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Hammadi HA, Hameed WA, Fakhri MA, Khazaal HM, Abood FK, Hameed EK, Al-Ameri LT. Does Parkinson's disease affect sleep quality? Ir J Med Sci 2024; 193:2035-2039. [PMID: 38625658 DOI: 10.1007/s11845-024-03689-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 04/11/2024] [Indexed: 04/17/2024]
Abstract
BACKGROUND Parkinson's disease (PD) is a common neurodegenerative disease that is linked to several motor and nonmotor symptoms, including sleep disturbances. Patient quality of life has been shown to be disproportionally impacted by disease. OBJECTIVES To investigate sleep quality among individuals with PD, and to assess the severity of sleep disturbances and their impact on daytime activities. SUBJECTS AND METHODS A case‒control with 44 patients with Parkinson's disease and 80 apparently healthy control participants was recruited from several hospitals and clinics. Each participant provided a thorough medical history and underwent a physical examination, and a questionnaire comprising the standard PSQI was used to assess sleep quality. Independent samples t test and Spearman's correlation analysis were used with a p value equal to or less than 0.05 which was considered significant. RESULTS The mean global PSQI score was 11.55 ± 4.412 for PD patients and 5.73 ± 3.22 for the control group with significant p value, Sleep latency onset was 75.57 min for PD patients and 22.81 min for the control group with significant p value. There was no significant correlation between age and other sleep-related variables. A total of 86.4% of patients with Parkinson's disease suffered from varying degrees of daytime dysfunction compared to 61.25% of the controls. CONCLUSION Parkinson's disease patients had poorer sleep quality than the controls. Age and sex were not found to be expected as a factor for sleep quality in patients with Parkinson's disease. Daytime dysfunction rates are high in patients with Parkinson's disease.
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Helaakoski V, Zellers S, Hublin C, Ollila HM, Latvala A. Associations between sleep medication use and alcohol consumption over 36 years in Finnish twins. Alcohol 2023:S0741-8329(23)00344-0. [PMID: 38101525 DOI: 10.1016/j.alcohol.2023.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 11/23/2023] [Accepted: 12/12/2023] [Indexed: 12/17/2023]
Abstract
BACKGROUND Sleep medication use is an indicator of underlying sleep problems that might be induced by various factors such as alcohol use. However, the longitudinal relationship between drinking and sleep problems remains poorly understood. We investigated associations between sleep medication and alcohol use throughout adulthood, and examined the role of familial and potential confounding factors contributing to these associations. METHODS We used information of zygosity and self-report questionnaire data over a follow-up period of 36 years from the Older Finnish Twin Cohort (N=13,851). RESULTS Logistic regression analyses suggested consistent associations between sleep medication use and heavy/binge drinking at all four time points (OR range =1.36-3.18, P <0.05), implying that increased drinking is associated with increased sleep medication use over time. Cross-lagged path analyses suggested that moderate/heavy and binge drinking predict sleep medication use at most time points (OR range = 1.15-1.94, P <0.05), whilst sleep medication use predicts subsequent abstaining from alcohol (OR range =2.26-2.47, P <0.05). Within-pair analyses implied that familial factors play a role, and quantitative genetic modelling estimated genetic factors to explain approximately 80% of the lifetime association of sleep medication use with moderate/heavy and binge drinking. CONCLUSIONS Drinking is associated with sleep medication use throughout adulthood. Further, our results suggest that drinking is likely to predict sleep medication use, thereby potentially constituting a risk factor for sleep problems, and that genetic factors contribute to the association. These findings are important in terms of better understanding the development of sleep and alcohol use disorders.
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Affiliation(s)
- Viola Helaakoski
- Institute for Molecular Medicine Finland, HiLIFE, University of Helsinki, Helsinki, Finland.
| | - Stephanie Zellers
- Institute for Molecular Medicine Finland, HiLIFE, University of Helsinki, Helsinki, Finland
| | - Christer Hublin
- Finnish Institute of Occupational Health, Helsinki, Finland; Department of Public Health, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Hanna M Ollila
- Institute for Molecular Medicine Finland, HiLIFE, University of Helsinki, Helsinki, Finland; Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA; Center for Genomic Medicine, Massachusetts General Hospital, Boston, USA; Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, USA
| | - Antti Latvala
- Institute of Criminology and Legal Policy, University of Helsinki, Helsinki, Finland
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Palagini L, Geoffroy PA, Gehrman PR, Miniati M, Gemignani A, Riemann D. Potential genetic and epigenetic mechanisms in insomnia: A systematic review. J Sleep Res 2023; 32:e13868. [PMID: 36918298 DOI: 10.1111/jsr.13868] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 02/14/2023] [Accepted: 02/17/2023] [Indexed: 03/16/2023]
Abstract
Insomnia is a stress-related sleep disorder conceptualised within a diathesis-stress framework, which it is thought to result from predisposing factors interacting with precipitating stressful events that trigger the development of insomnia. Among predisposing factors genetics and epigenetics may play a role. A systematic review of the current evidence for the genetic and epigenetic basis of insomnia was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) system. A total of 24 studies were collected for twins and family heritability, 55 for genome-wide association studies, 26 about candidate genes for insomnia, and eight for epigenetics. Data showed that insomnia is a complex polygenic stress-related disorder, and it is likely to be caused by a synergy of genetic and environmental factors, with stress-related sleep reactivity being the important trait. Even if few studies have been conducted to date on insomnia, epigenetics may be the framework to understand long-lasting consequences of the interaction between genetic and environmental factors and effects of stress on the brain in insomnia. Interestingly, polygenic risk for insomnia has been causally linked to different mental and medical disorders. Probably, by treating insomnia it would be possible to intervene on the effect of stress on the brain and prevent some medical and mental conditions.
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Affiliation(s)
- Laura Palagini
- Department of Clinical and Experimental Medicine, Unit of Psychiatry, Azienda Ospedaliero Universitaria Pisana AUOP, Pisa, Italy
| | - Pierre A Geoffroy
- Département de Psychiatrie et D'Addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hopital Bichat - Claude Bernard, Paris, France
- GHU Paris - Psychiatry and Neurosciences, Paris, France
- Université de Paris, NeuroDiderot, INSERM, Paris, France
| | - Philip R Gehrman
- Center for Sleep and Circadian Neurobiology, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Department of Psychiatry, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Mario Miniati
- Department of Clinical and Experimental Medicine, Unit of Psychiatry, Azienda Ospedaliero Universitaria Pisana AUOP, Pisa, Italy
| | - Angelo Gemignani
- Unit of Psychology, Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Azienda Ospedaliero Universitaria Pisana AUOP, Pisa, Italy
| | - Dieter Riemann
- Department of Psychiatry and Psychotherapy, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
- Center for Basics in NeuroModulation (NeuroModulBasics), Faculty of Medicine, University of Freiburg, Freiburg, Germany
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Hublin C, Kaprio J. Chronotype and mortality - a 37-year follow-up study in Finnish adults. Chronobiol Int 2023; 40:841-849. [PMID: 37322846 DOI: 10.1080/07420528.2023.2215342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 05/03/2023] [Accepted: 05/12/2023] [Indexed: 06/17/2023]
Abstract
The UK Biobank study on chronotype and mortality suggested small increases of all-cause and cardiovascular mortality in a 6.5-year follow-up. Our aim was to constructively replicate findings from it in a longer follow-up. A questionnaire was administered to the population-based adult Finnish Twin Cohort in 1981 (response rate 84%). The study population included 23 854 participants who replied to the question: "Try to assess to what extent you are a morning person or an evening person," with four response alternatives (anchored from "clearly a morning person" to "clearly an evening person"). Vital status and cause of death data were provided by nationwide registers up to the end of 2018. Hazard ratios for mortality were computed based on 8728 deaths. Adjustments were made for education, alcohol, smoking, BMI, and sleep duration. The covariate adjusted model showed a 9% increase of all-cause mortality for the evening-type group (HR = 1.09, 95% CI 1.01-1.18), with attenuation mainly due to smoking and alcohol. Their importance was highlighted by observing no increased mortality among non-smokers who were at most light drinkers. There was no increase in any cause-specific mortality. Our results suggest that there is little or no independent contribution of chronotype to mortality.
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Affiliation(s)
- Christer Hublin
- Working Ability and Working Careers, Finnish Institute of Occupational Health, Helsinki, Finland
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Jaakko Kaprio
- Department of Public Health, University of Helsinki, Helsinki, Finland
- Institute for Molecular Medicine Finland FIMM, University of Helsinki, Helsinki, Finland
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Madrid‐Valero JJ, Rijsdijk F, Selzam S, Zavos HMS, Schneider M, Ronald A, Gregory AM. Sub-types of insomnia in adolescents: Insights from a quantitative/molecular twin study. JCPP ADVANCES 2023; 3:e12167. [PMID: 37753157 PMCID: PMC10519740 DOI: 10.1002/jcv2.12167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 03/30/2023] [Indexed: 09/28/2023] Open
Abstract
Background Insomnia with short sleep duration has been postulated as more severe than that accompanied by normal/long sleep length. While the short duration subtype is considered to have greater genetic influence than the other subtype, no studies have addressed this question. This study aimed to compare these subtypes in terms of: (1) the heritability of insomnia symptoms; (2) polygenic scores (PGS) for insomnia symptoms and sleep duration; (3) the associations between insomnia symptoms and a wide variety of traits/disorders. Methods The sample comprised 4000 pairs of twins aged 16 from the Twins Early Development Study. Twin models were fitted to estimate the heritability of insomnia in both groups. PGS were calculated for self-reported insomnia and sleep duration and compared among participants with short and normal/long sleep duration. Results Heritability was not significantly different in the short sleep duration group (A = 0.13 [95%CI = 0.01, 0.32]) and the normal/long sleep duration group (A = 0.35 [95%CI = 0.29, 0.40]). Shared environmental factors accounted for a substantial proportion of the variance in the short sleep duration group (C = 0.19 [95%CI = 0.05, 0.32]) but not in the normal/long sleep duration group (C = 0.00 [95%CI = 0.00, 0.04]). PGS did not differ significantly between groups although results were in the direction expected by the theory. Our results also showed that insomnia with short (as compared to normal/long) sleep duration had a stronger association with anxiety and depression (p < .05)-although not once adjusting for multiple testing. Conclusions We found mixed results in relation to the expected differences between the insomnia subtypes in adolescents. Future research needs to further establish cut-offs for 'short' sleep at different developmental stages and employ objective measures of sleep.
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Affiliation(s)
- Juan J. Madrid‐Valero
- Department of Health PsychologyFaculty of Health SciencesUniversity of AlicanteAlicanteSpain
| | - Frühling Rijsdijk
- Social, Genetic and Developmental Psychiatry CentreInstitute of Psychiatry, Psychology & NeuroscienceKing's College LondonLondonUK
| | - Saskia Selzam
- Social, Genetic and Developmental Psychiatry CentreInstitute of Psychiatry, Psychology & NeuroscienceKing's College LondonLondonUK
| | - Helena M. S. Zavos
- Department of PsychologyInstitute of Psychiatry, Psychology & NeuroscienceKing's College LondonLondonUK
| | | | - Angelica Ronald
- Department of Psychological SciencesBirkbeck, University of LondonLondonUK
| | - Alice M. Gregory
- Department of PsychologyGoldsmiths, University of LondonLondonUK
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Madrid-Valero JJ, Gregory AM. Behaviour genetics and sleep: A narrative review of the last decade of quantitative and molecular genetic research in humans. Sleep Med Rev 2023; 69:101769. [PMID: 36933344 DOI: 10.1016/j.smrv.2023.101769] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 02/21/2023] [Accepted: 02/22/2023] [Indexed: 03/05/2023]
Abstract
During the last decade quantitative and molecular genetic research on sleep has increased considerably. New behavioural genetics techniques have marked a new era for sleep research. This paper provides a summary of the most important findings from the last ten years, on the genetic and environmental influences on sleep and sleep disorders and their associations with health-related variables (including anxiety and depression) in humans. In this review we present a brief summary of the main methods in behaviour genetic research (such as twin and genome-wide association studies). We then discuss key research findings on: genetic and environmental influences on normal sleep and sleep disorders, as well as on the association between sleep and health variables (highlighting a substantial role for genes in individual differences in sleep and their associations with other variables). We end by discussing future lines of enquiry and drawing conclusions, including those focused on problems and misconceptions associated with research of this type. In this last decade our knowledge about genetic and environmental influences on sleep and its disorders has expanded. Both, twin and genome-wide association studies show that sleep and sleep disorders are substantially influenced by genetic factors and for the very first time multiple specific genetic variants have been associated with sleep traits and disorders.
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Affiliation(s)
- Juan J Madrid-Valero
- Department of Health Psychology, Faculty of Health Sciences, University of Alicante, Spain.
| | - Alice M Gregory
- Department of Psychology, Goldsmiths, University of London, London, United Kingdom
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Examining and Promoting Sleep Health in the Undergraduate Classroom: A Mixed-Methods Approach. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312297. [PMID: 34886017 PMCID: PMC8656841 DOI: 10.3390/ijerph182312297] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 10/21/2021] [Accepted: 10/22/2021] [Indexed: 11/16/2022]
Abstract
Objective: Although college students are at heightened risk for sleep disturbances, healthy sleep is associated with positive physical, cognitive, psychological, and academic benefits for this group. The goals of the current study were to (1) describe sleep health in an undergraduate college sample and (2) examine the role of a class activity using self-determination theory to promote better sleep health in this group. Methods: A cohort study was conducted using data drawn from class activities conducted in two undergraduate Introduction to Psychology courses. Students were undergraduates at a mid-Atlantic public university in the United States. Total sample size was N = 224 (intervention class [n = 98], and the control class [n = 127]). Both the intervention and control classes completed the RU SATED sleep health questionnaire at the beginning and the end of the semester. The intervention class also completed a self-determination activity focused on sleep health mid-semester. Both the RU SATED questionnaires and the self-determination activities were completed via in-class responder technology. Data were de-identified and downloaded from the responder technology at the end of the semester. Mixed methods were used for data analysis including quantitative analyses and a qualitative approach using a phenomenological, inductive, and reflexive qualitative method whereby themes were allowed to emerge from the data. Results: Overall, almost 25% of the students reported never or rarely obtaining healthy sleep on average. The majority (76%) said they sometimes have healthy sleep and no students reported usually or always obtaining healthy sleep. The components of sleep health the entire sample scored highest on were timing (sleeping between 2 and 4 AM), sleep duration (between 7 and 9 h), and staying awake during the day. The areas they scored the lowest on were maintaining regular bed and wake times, spending less than 30 min awake at night, and feeling satisfied with their sleep. Qualitatively, the most frequently obtained sleep health behaviors of the intervention class were rhythmicity, prioritizing sleep, timing of sleep, and tech hygiene. The intervention class had significantly better sleep health across the entire semester and significantly better daytime alertness post-intervention. The most commonly chosen sleep health behaviors to change were sleep hygiene, tech hygiene, and stimulus control. Conclusion: We examined the classroom environment as a venue for promoting sleep health among college students. Given the popularity of Introduction to Psychology courses, this class is a promising avenue to deliver sleep health promotions to a large number of students. The implementation of a self-determination framework, as part of sleep health promotion, shows potential for creating a person-centered, strengths-based approach to health behavior change within this population.
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Mota IA, Oliveira Sobrinho GDD, Morais IPS, Dantas TF. Impact of COVID-19 on eating habits, physical activity and sleep in Brazilian healthcare professionals. ARQUIVOS DE NEURO-PSIQUIATRIA 2021; 79:429-436. [PMID: 34037163 DOI: 10.1590/0004-282x-anp-2020-0482] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Accepted: 02/16/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND During the coronavirus disease 2019 (COVID-19) pandemic, Brazilian healthcare professionals could have been experiencing impacts on their routine, behavior and mental health. OBJECTIVE To investigate changes in the daily life and sleeping habits of healthcare professionals in Brazil. METHODS We conducted an observational and cross-sectional study from May to July 2020. A Google Forms questionnaire was made available to Brazilian healthcare professionals on the WhatsApp mobile application and through the website of the Brazilian Hospital Services Company. RESULTS The sample (n=710) was mostly composed of women (80.8%), aged between 30 and 40 years old (46.6%), predominantly physicians (41.8%) and residing mostly in the state of Paraíba (66.9%), Brazil. Approximately two-thirds of the total sample had some sleep-related complaints, 25.8% due to difficulty initiating sleep, 29.6% due to difficulty staying asleep and 32.5% due to early morning waking. From the population studied, 28.7% (n=204) reported the use of insomnia medication, and 60.3% (n=123) of these were self-medicating. Some participants reported a change in diet (n=557; 78.5%), especially related to the increase in carbohydrate intake (n=174; 24.5%), and 27% (n=192) of the individuals reported an increase of the consumption of alcoholic beverages. Of the total, 561 (81.8%) reported a change in the practice of physical activity. CONCLUSION In this study, Brazilian healthcare professionals showed aspects of quality of life that were more affected during the COVID-19 pandemic than the prevalence seen in surveys of international studies for the general population.
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Ma T, Chen H, Lu Q, Tong X. Polygenic Risk for Insomnia in Adolescents of Diverse Ancestry. Front Genet 2021; 12:654717. [PMID: 34040634 PMCID: PMC8141920 DOI: 10.3389/fgene.2021.654717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Accepted: 03/29/2021] [Indexed: 12/02/2022] Open
Abstract
Background: Insomnia is a common mental disorder, affecting nearly one fifth of the pre-adult population in the United States. The recent, largest genome-wide association study (GWAS) conducted on the United Kingdom Biobank cohort identified hundreds of significant single-nucleotide polymorphism (SNP), allowing the epidemiologists to quantify individual genetic predisposition in the subsequent studies via the polygenic risk scoring technique. The nucleotide polymorphisms and risk scoring, while being able to generalize to other adult populations of European origin, are not yet tested on pediatric and adolescent populations of diverse racial-ethnic backgrounds, and our study intends to fill these gaps. Materials and Methods: We took the summary of the same United Kingdom Biobank study and conducted a polygenic risk score (PRS) analysis on a multi-ethnicity, pre-adult population provided by the Adolescent Brain Cognitive Development (ABCD) Study. Results: The PRSs according to the significant nucleotide polymorphisms found in white British adults is a strong predictor of insomnia in children of similar European background but lacks power in non-European groups. Conclusions: Through polygenic risk scoring, the knowledge of insomnia genetics summarized from a white adult study population is transferable to a younger age group, which aids the search of actionable targets of early insomnia prevention. Yet population stratification may prevent the easy generalization across ethnic lines; therefore, it is necessary to conduct group specific studies to aid people of non-European genetic background.
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Affiliation(s)
- Tengfei Ma
- Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, East Lansing, MI, United States
| | - Honglei Chen
- Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, East Lansing, MI, United States
| | - Qing Lu
- Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, East Lansing, MI, United States.,Department of Biostatistics, College of Public Health and Health Professionals and College of Medicine, University of Florida, Gainesville, FL, United States
| | - Xiaoran Tong
- Biostatistics and Computational Biology, National Institute of Environmental Health Sciences, Durham, NC, United States
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Madrid-Valero JJ, Chapman R, Bailo E, Ordoñana JR, Selita F, Kovas Y, Gregory AM. What Do People Know About the Heritability of Sleep? Behav Genet 2021; 51:144-153. [PMID: 33486622 DOI: 10.1007/s10519-021-10041-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 01/06/2021] [Indexed: 11/29/2022]
Abstract
STUDY OBJECTIVES Twin studies have provided data about the relative weight of genetic and environmental factors on sleep variables over the last few decades. However, heritability is a non-intuitive concept and it is often misunderstood even amongst the scientific community. This study aimed to analyze: (1) understanding of the meaning of heritability of insomnia; (2) the accuracy of estimations of heritability in the general population regarding three sleep traits (sleep duration, sleep quality and insomnia); (3) perceptions of the effectiveness of different treatments for insomnia depending on how the disorder is presented (i.e. having an environmental or genetic etiology) and whether the subject's estimate of genetic influence on sleep traits impacted beliefs about the effectiveness of different treatments. METHODS Participants (N = 3658) completed a survey which included: questions about general genetic knowledge; a specific question about the meaning of heritability; estimates of heritability of three different sleep traits; and the effectiveness of different treatments for insomnia depending on how the etiology of this condition was presented. RESULTS Fewer than 25% of the participants selected the correct description of the heritability of insomnia. Almost half of the sample incorrectly believed that heritability refers to the chance of passing a disorder onto their children. We also found that participants provided different estimates for the effectiveness of different treatments depending on the presumed etiology of the disorder. CONCLUSION Most people do not have accurate knowledge about the concept of heritability. People's assumptions about the etiology of a disorder may influence which treatments they consider most effective.
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Affiliation(s)
- Juan J Madrid-Valero
- Department of Health Psychology, Faculty of Health Science, University of Alicante, 03690, Alicante, Spain.
| | - Robert Chapman
- Department of Psychology, Goldsmiths, University of London, London, UK
| | - Evangelina Bailo
- Department of Psychology, Goldsmiths, University of London, London, UK
| | - Juan R Ordoñana
- Department of Human Anatomy and Psychobiology, University of Murcia, Murcia, Spain.,Murcia Institute of Biomedical Research, IMIB-Arrixaca, Murcia, Spain
| | - Fatos Selita
- Department of Psychology, Goldsmiths, University of London, London, UK.,Tomsk State University, Tomsk, Russia
| | - Yulia Kovas
- Department of Psychology, Goldsmiths, University of London, London, UK.,Tomsk State University, Tomsk, Russia
| | - Alice M Gregory
- Department of Psychology, Goldsmiths, University of London, London, UK
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Madrid-Valero JJ, Rubio-Aparicio M, Gregory AM, Sánchez-Meca J, Ordoñana JR. The heritability of insomnia: Systematic review and meta-analysis of twin studies. Sleep Med Rev 2021; 58:101437. [PMID: 33556853 DOI: 10.1016/j.smrv.2021.101437] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 10/07/2020] [Accepted: 11/13/2020] [Indexed: 10/22/2022]
Abstract
Twin studies have consistently found that genetic factors explain a substantial proportion of the variance for insomnia. However, studies vary widely in their heritability estimates. Therefore, this meta-analysis aimed to: 1) Estimate the mean heritability of insomnia; 2) Assess heterogeneity among twin studies of insomnia; and 3) Search and analyse characteristics of the studies (moderator variables) that may explain heterogeneity among estimates. For this purpose, separate meta-analyses were carried out for MZ and DZ correlations and for heritability estimates by assuming random-effects models. Thirteen independent samples were included in this meta-analysis. The heterogeneity index for heritability estimates was significant in both best fitting models (I2 = 98.77, P < .0001) and full models (I2 = 97.80, P < .0001). MZ correlations were higher (0.37; 95%CI: 0.31,.43) than DZ correlations (0.15; 95%CI: 0.12,.18). A mean heritability of 0.39 (95%CI: 0.32,.44) was found for insomnia. These results highlight the role of genetic factors in explaining differences among the population on insomnia and Emphasize heterogeneity among studies. Further research is needed to identify variables that could explain this heterogeneity.
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Affiliation(s)
- Juan J Madrid-Valero
- Department of Health Psychology, Faculty of Health Science, University of Alicante, Spain.
| | - María Rubio-Aparicio
- Department of Health Psychology, Faculty of Health Science, University of Alicante, Spain
| | - Alice M Gregory
- Department of Psychology, Goldsmiths, University of London, London, United Kingdom
| | - Julio Sánchez-Meca
- Department of Basic Psychology and Methodology, University of Murcia, Spain
| | - Juan R Ordoñana
- Department of Human Anatomy and Psychobiology, University of Murcia, Spain; Murcia Institute of Biomedical Research, IMIB-Arrixaca, Spain
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Liu K, Zhu L, Yu M, Liang X, Zhang J, Tan Y, Huang C, He W, Lei W, Chen J, Gu X, Xiang B. A Combined Analysis of Genetically Correlated Traits Identifies Genes and Brain Regions for Insomnia. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2020; 65:874-884. [PMID: 32648482 PMCID: PMC7658420 DOI: 10.1177/0706743720940547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
AIMS Previous studies have inferred that there is a strong genetic component in insomnia. However, the etiology of insomnia is still unclear. This study systematically analyzed multiple genome-wide association study (GWAS) data sets with core human pathways and functional networks to detect potential gene pathways and networks associated with insomnia. METHODS We used a novel method, multitrait analysis of genome-wide association studies (MTAG), to combine 3 large GWASs of insomnia symptoms/complaints and sleep duration. The i-Gsea4GwasV2 and Reactome FI programs were used to analyze data from the result of MTAG analysis and the nominally significant pathways, respectively. RESULTS Through analyzing data sets using the MTAG program, our sample size increased from 113,006 subjects to 163,188 subjects. A total of 17 of 1,816 Reactome pathways were identified and showed to be associated with insomnia. We further revealed 11 interconnected functional and topologically interacting clusters (Clusters 0 to 10) that were associated with insomnia. Based on the brain transcriptome data, it was found that the genes in Cluster 4 were enriched for the transcriptional coexpression profile in the prenatal dorsolateral prefrontal cortex (P = 7 × 10-5), inferolateral temporal cortex (P = 0.02), medial prefrontal cortex (P < 1 × 10-5), and amygdala (P < 1 × 10-5), and detected RPA2, ORC6, PIAS3, and PRIM2 as core nodes in these 4 brain regions. CONCLUSIONS The findings provided new genes, pathways, and brain regions to understand the pathology of insomnia.
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Affiliation(s)
- Kezhi Liu
- Department of Psychiatry, Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | - Ling Zhu
- Department of Psychiatry, Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | - Minglan Yu
- Medical Laboratory Center, Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | - Xuemei Liang
- Department of Psychiatry, Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | - Jin Zhang
- Department of Psychiatry, Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | - Youguo Tan
- Zigong Mental Health Center, Zigong, Sichuan, China
| | - Chaohua Huang
- Department of Psychiatry, Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | - Wenying He
- Department of Psychiatry, Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | - Wei Lei
- Department of Psychiatry, Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | - Jing Chen
- Department of Psychiatry, Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | - Xiaochu Gu
- Clinical Laboratory, Suzhou Guangji Hospital, Suzhou, Jiangsu, China
| | - Bo Xiang
- Department of Psychiatry, Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
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13
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Barclay NL, Kocevska D, Bramer WM, Van Someren EJW, Gehrman P. The heritability of insomnia: A meta-analysis of twin studies. GENES BRAIN AND BEHAVIOR 2020; 20:e12717. [PMID: 33222383 DOI: 10.1111/gbb.12717] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 11/18/2020] [Accepted: 11/19/2020] [Indexed: 12/21/2022]
Abstract
Twin studies of insomnia exhibit heterogeneity in estimates of heritability. This heterogeneity is likely because of sex differences, age of the sample, the reporter and the definition of insomnia. The aim of the present study was to systematically search the literature for twin studies investigating insomnia disorder and insomnia symptoms and to meta-analyse the estimates of heritability derived from these studies to generate an overall estimate of heritability. We further examined whether heritability was moderated by sex, age, reporter and insomnia symptom. A systematic literature search of five online databases was completed on 24 January 2020. Two authors independently screened 5644 abstracts, and 160 complete papers for the inclusion criteria of twin studies from the general population reporting heritability statistics on insomnia or insomnia symptoms, written in English, reporting data from independent studies. We ultimately included 12 papers in the meta-analysis. The meta-analysis focussed on twin intra-class correlations for monozygotic and dizygotic twins. Based on these intra-class correlations, the meta-analytic estimate of heritability was estimated at 40%. Moderator analyses showed stronger heritability in females than males; and for parent-reported insomnia symptoms compared with self-reported insomnia symptoms. There were no other significant moderator effects, although this is likely because of the small number of studies that were comparable across levels of the moderators. Our meta-analysis provides a robust estimate of the heritability of insomnia, which can inform future research aiming to uncover molecular genetic factors involved in insomnia vulnerability.
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Affiliation(s)
- Nicola L Barclay
- Sleep and Circadian Neuroscience Institute, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Desi Kocevska
- Department of Sleep and Cognition, Netherlands Institute for Neuroscience, an Institute of the Royal Netherlands Society for Arts and Sciences, Amsterdam, The Netherlands
| | - Wichor M Bramer
- Medical Library, Erasmus MC - University Hospital Rotterdam, Rotterdam, The Netherlands
| | - Eus J W Van Someren
- Department of Sleep and Cognition, Netherlands Institute for Neuroscience, an Institute of the Royal Netherlands Society for Arts and Sciences, Amsterdam, The Netherlands.,Departments of Integrative Neurophysiology and Psychiatry, Center for Neurogenomics and Cognitive Research, VU University, Amsterdam UMC, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Philip Gehrman
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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14
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Park K, Cho D, Lee E, Kim J, Shim JS, Youm Y, An SK, Namkoong K, Kim HC. Sex differences in the association between social relationships and insomnia symptoms. J Clin Sleep Med 2020; 16:1871-1881. [PMID: 32713419 PMCID: PMC8034209 DOI: 10.5664/jcsm.8710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Revised: 07/17/2020] [Accepted: 07/17/2020] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES Social relationships are an understudied factor affecting insomnia. In particular, these effects have not been evaluated in the context of sex differences. In this study, we investigated differences between sexes with regard to the association between insomnia symptoms and social relationships. METHODS We used data from 2681 middle-aged adults (aged 40-64 years; females, 68.8%) from the Cardiovascular and Metabolic Diseases Etiology Research Center project. Insomnia symptoms were defined as difficulty with sleep induction or maintenance ≥3 nights per week. We assessed social network size and bridging potentials as indicators of social relationships. Social network size is a quantitative measure of the size of social relationships, and bridging potential is a qualitative indicator of the diversity and independence of these relationships. Multivariate regression analysis controlling for confounding factors was performed to evaluate associations between social relationships and insomnia symptoms. RESULTS Smaller social network size was significantly associated with sleep induction (adjusted odds ratio = 0.866, P = .015) and sleep maintenance (adjusted odds ratio = 0.862, P = .015) difficulties, but only in men. Poor bridging potential was also associated with sleep induction (adjusted odds ratio = 0.321, P = .024) and maintenance (adjusted odds ratio = 0.305, P = .031) difficulties only in men. For women, social relationship variables were not significantly associated with insomnia symptoms. CONCLUSIONS The association between insomnia symptoms and social relationships varied by sex, as noted by statistical analyses accounting for covariates affecting insomnia symptoms. These results suggest that qualitative assessments of social relationship variables should be considered in clinical practice, since these variables can be interpreted differently for men and women.
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Affiliation(s)
- Kyungmee Park
- Department of Psychiatry and Institute of Behavioral Science in Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
- Department of Hospital Medicine, Yongin Dongbaek Severance Hospital, Seoul, Republic of Korea
| | - Daol Cho
- Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Eun Lee
- Department of Psychiatry and Institute of Behavioral Science in Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Junsol Kim
- Department of Sociology, Yonsei University College of Social Sciences, Seoul, Korea
| | - Jee-Seon Shim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
- Cardiovascular and Metabolic Diseases Etiology Research Center, Yonsei University College of Medicine, Seoul, Korea
| | - Yoosik Youm
- Department of Sociology, Yonsei University College of Social Sciences, Seoul, Korea
| | - Suk Kyoon An
- Department of Psychiatry and Institute of Behavioral Science in Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Kee Namkoong
- Department of Psychiatry and Institute of Behavioral Science in Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Hyeon Chang Kim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
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15
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Berryhill S, Morton CJ, Dean A, Berryhill A, Provencio-Dean N, Patel SI, Estep L, Combs D, Mashaqi S, Gerald LB, Krishnan JA, Parthasarathy S. Effect of wearables on sleep in healthy individuals: a randomized crossover trial and validation study. J Clin Sleep Med 2020; 16:775-783. [PMID: 32043961 DOI: 10.5664/jcsm.8356] [Citation(s) in RCA: 71] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES The purpose of this study was to determine whether a wearable sleep-tracker improves perceived sleep quality in healthy participants and to test whether wearables reliably measure sleep quantity and quality compared with polysomnography. METHODS This study included a single-center randomized crossover trial of community-based participants without medical conditions or sleep disorders. A wearable device (WHOOP, Inc.) was used that provided feedback regarding sleep information to the participant for 1 week and maintained sleep logs versus 1 week of maintained sleep logs alone. Self-reported daily sleep behaviors were documented in sleep logs. Polysomnography was performed on 1 night when wearing the wearable. The Patient-Reported Outcomes Measurement Information System sleep disturbance sleep scale was measured at baseline, day 7 and day 14 of study participation. RESULTS In 32 participants (21 women; 23.8 ± 5 years), wearables improved nighttime sleep quality (Patient-Reported Outcomes Measurement Information System sleep disturbance: B = -1.69; 95% confidence interval, -3.11 to -0.27; P = .021) after adjusting for age, sex, baseline, and order effect. There was a small increase in self-reported daytime naps when wearing the device (B = 3.2; SE, 1.4; P = .023), but total daily sleep remained unchanged (P = .43). The wearable had low bias (13.8 minutes) and precision (17.8 minutes) errors for measuring sleep duration and measured dream sleep and slow wave sleep accurately (intraclass coefficient, 0.74 ± 0.28 and 0.85 ± 0.15, respectively). Bias and precision error for heart rate (bias, -0.17%; precision, 1.5%) and respiratory rate (bias, 1.8%; precision, 6.7%) were very low compared with that measured by electrocardiogram and inductance plethysmography during polysomnography. CONCLUSIONS In healthy people, wearables can improve sleep quality and accurately measure sleep and cardiorespiratory variables. CLINICAL TRIAL REGISTRATION Registry: ClinicalTrials.gov; Name: Assessment of Sleep by WHOOP in Ambulatory Subjects; Identifier: NCT03692195.
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Affiliation(s)
- Sarah Berryhill
- University of Arizona Health Sciences Center for Sleep and Circadian Sciences, University of Arizona, Tucson, Arizona
| | - Christopher J Morton
- University of Arizona Health Sciences Center for Sleep and Circadian Sciences, University of Arizona, Tucson, Arizona
| | - Adam Dean
- University of Arizona Health Sciences Center for Sleep and Circadian Sciences, University of Arizona, Tucson, Arizona
| | - Adam Berryhill
- University of Arizona Health Sciences Center for Sleep and Circadian Sciences, University of Arizona, Tucson, Arizona
| | - Natalie Provencio-Dean
- University of Arizona Health Sciences Center for Sleep and Circadian Sciences, University of Arizona, Tucson, Arizona
| | - Salma I Patel
- University of Arizona Health Sciences Center for Sleep and Circadian Sciences, University of Arizona, Tucson, Arizona.,Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona, Tucson, Arizona
| | - Lauren Estep
- University of Arizona Health Sciences Center for Sleep and Circadian Sciences, University of Arizona, Tucson, Arizona.,Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona, Tucson, Arizona
| | - Daniel Combs
- University of Arizona Health Sciences Center for Sleep and Circadian Sciences, University of Arizona, Tucson, Arizona.,Department of Pediatrics, University of Arizona, Tucson, Arizona
| | - Saif Mashaqi
- University of Arizona Health Sciences Center for Sleep and Circadian Sciences, University of Arizona, Tucson, Arizona.,Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona, Tucson, Arizona
| | - Lynn B Gerald
- Asthma and Airway Diseases Research Center, University of Arizona, Tucson, Arizona
| | - Jerry A Krishnan
- Breathe Chicago Center, Division of Pulmonary, Critical Care, Sleep, & Allergy, University of Illinois, Chicago, Illinois
| | - Sairam Parthasarathy
- University of Arizona Health Sciences Center for Sleep and Circadian Sciences, University of Arizona, Tucson, Arizona.,Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona, Tucson, Arizona
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16
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Twin studies of subjective sleep quality and sleep duration, and their behavioral correlates: Systematic review and meta-analysis of heritability estimates. Neurosci Biobehav Rev 2020; 109:78-89. [DOI: 10.1016/j.neubiorev.2019.12.028] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2019] [Revised: 12/04/2019] [Accepted: 12/23/2019] [Indexed: 12/28/2022]
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17
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Angelin TJ, Mota KR, Santos Júnior VED, Silva LC, Heimer MV. Evaluation of Sleep Quality and Daytime Sleepiness in Dentistry Students. PESQUISA BRASILEIRA EM ODONTOPEDIATRIA E CLÍNICA INTEGRADA 2020. [DOI: 10.1590/pboci.2020.122] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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18
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Baglioni C, Altena E, Bjorvatn B, Blom K, Bothelius K, Devoto A, Espie CA, Frase L, Gavriloff D, Tuuliki H, Hoflehner A, Högl B, Holzinger B, Järnefelt H, Jernelöv S, Johann AF, Lombardo C, Nissen C, Palagini L, Peeters G, Perlis ML, Posner D, Schlarb A, Spiegelhalder K, Wichniak A, Riemann D. The European Academy for Cognitive Behavioural Therapy for Insomnia: An initiative of the European Insomnia Network to promote implementation and dissemination of treatment. J Sleep Res 2019; 29:e12967. [PMID: 31856367 DOI: 10.1111/jsr.12967] [Citation(s) in RCA: 111] [Impact Index Per Article: 22.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Revised: 11/13/2019] [Accepted: 11/21/2019] [Indexed: 12/18/2022]
Abstract
Insomnia, the most prevalent sleep disorder worldwide, confers marked risks for both physical and mental health. Furthermore, insomnia is associated with considerable direct and indirect healthcare costs. Recent guidelines in the US and Europe unequivocally conclude that cognitive behavioural therapy for insomnia (CBT-I) should be the first-line treatment for the disorder. Current treatment approaches are in stark contrast to these clear recommendations, not least across Europe, where, if any treatment at all is delivered, hypnotic medication still is the dominant therapeutic modality. To address this situation, a Task Force of the European Sleep Research Society and the European Insomnia Network met in May 2018. The Task Force proposed establishing a European CBT-I Academy that would enable a Europe-wide system of standardized CBT-I training and training centre accreditation. This article summarizes the deliberations of the Task Force concerning definition and ingredients of CBT-I, preconditions for health professionals to teach CBT-I, the way in which CBT-I should be taught, who should be taught CBT-I and to whom CBT-I should be administered. Furthermore, diverse aspects of CBT-I care and delivery were discussed and incorporated into a stepped-care model for insomnia.
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Affiliation(s)
- Chiara Baglioni
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, Medical Center - University of Freiburg, University of Freiburg, Freiburg, Germany.,Department of Human Sciences, University of Rome 'G. Marconi' - Telematic, Rome, Italy
| | - Ellemarije Altena
- UMR 5287, Institut de Neurosciences Intégratives et Cognitives d'Aquitaine, Neuroimagerie et Cognition Humaine, CNRS, Université de Bordeaux, Bordeaux, France
| | - Bjørn Bjorvatn
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Kerstin Blom
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, and Stockholm Health Care Services, Stockholm County Council, Huddinge Hospital, Stockholm, Sweden
| | | | | | - Colin A Espie
- Nuffield Department of Clinical Neuroscience, Sleep and Circadian Neuroscience Institute, University of Oxford, Oxford, UK
| | - Lukas Frase
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, Medical Center - University of Freiburg, University of Freiburg, Freiburg, Germany
| | - Dimitri Gavriloff
- Nuffield Department of Clinical Neuroscience, Sleep and Circadian Neuroscience Institute, University of Oxford, Oxford, UK
| | - Hion Tuuliki
- Nordic Sleep Centre, Tallinn, Estonia.,Tartu University Hospital, Tartu, Estonia
| | - Andrea Hoflehner
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Birgit Högl
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | | | - Heli Järnefelt
- Finnish Institute of Occupational Health, Helsinki, Finland.,Department of Psychology and Logopedics, University of Helsinki, Finland
| | - Susanna Jernelöv
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, and Stockholm Health Care Services, Stockholm County Council, Huddinge Hospital, Stockholm, Sweden.,Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Sweden
| | - Anna F Johann
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, Medical Center - University of Freiburg, University of Freiburg, Freiburg, Germany.,Medical Psychology and Medical Sociology, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Caterina Lombardo
- Department of Psychology, "Sapienza" University of Rome, Rome, Italy
| | - Christoph Nissen
- University Hospital of Psychiatry and Psychotherapy, Bern, Switzerland
| | - Laura Palagini
- Department of Neuroscience, University of Pisa, Pisa, Italy
| | - Geert Peeters
- Sleep Medicine Centre Kempenhaeghe, Heeze, The Netherlands
| | - Michael L Perlis
- Department of Psychiatry, Upenn Behavioral Sleep Medicine Program, University of Pennsylvania, Philadelphia, PA, USA
| | - Donn Posner
- Stanford University School of Medicine, Stanford, CA, USA
| | - Angelika Schlarb
- Department of Psychology, University of Bielefeld, Bielefeld, Germany
| | - Kai Spiegelhalder
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, Medical Center - University of Freiburg, University of Freiburg, Freiburg, Germany
| | - Adam Wichniak
- Sleep Medicine Centre and Third Department of Psychiatry, Institute of Psychiatry and Neurology, Warsaw, Poland
| | - Dieter Riemann
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, Medical Center - University of Freiburg, University of Freiburg, Freiburg, Germany
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19
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Barros MBDA, Lima MG, Ceolim MF, Zancanella E, Cardoso TAMDO. Quality of sleep, health and well-being in a population-based study. Rev Saude Publica 2019; 53:82. [PMID: 31576942 PMCID: PMC6763282 DOI: 10.11606/s1518-8787.2019053001067] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Accepted: 12/09/2018] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE To estimate the prevalence of poor self-rated sleep and to identify the population subgroups most susceptible to the problem. METHODS This is a cross-sectional, population-based study developed with data from the Health Survey conducted in the city of Campinas (ISACamp 2014/2015). Data from a sample of 1,998 individuals aged 20 years or older were analyzed. The self-rated quality of sleep was analyzed according to socio-demographic characteristics, morbidities, health behaviors and feeling of well-being. The association of sleep quality with different complaints and characteristics of sleep was also analyzed. Adjusted prevalence ratios were estimed using Poisson multiple regression model allowing for the sample weights. RESULTS Prevalence of poor self-rated sleep was 29.1% and showed to be significantly higher in women, in individuals aged from 40 to 50 years, migrants, without occupation, physically inactive in leisure context, with common mental disorder (PR = 1.59), with greater number of health problems (PR = 2.33), poor self-rated health (PR = 1.61), and life dissatisfaction. Poor sleep was strongly associated with reports of difficulty in initiating sleep (PR = 4.17), in maintaining sleep (PR = 4.40) and with never or almost never feeling well when waking up (PR = 4.52). CONCLUSIONS The results identify the population subgroups with poor quality of sleep that deserve greater attention. It also highlight the need to consider, in addition to the presence of comorbidities, mental health and the feeling of well-being in the care of patients with sleep problems and in the interventions planed for promoting healthy sleep.
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Affiliation(s)
- Marilisa Berti de Azevedo Barros
- Universidade Estadual de Campinas. Faculdade de Ciências Médicas. Departamento de Saúde de Coletiva. Campinas, São Paulo, Brasil
| | - Margareth Guimarães Lima
- Universidade Estadual de Campinas. Faculdade de Ciências Médicas. Departamento de Saúde de Coletiva. Campinas, São Paulo, Brasil
| | - Maria Filomena Ceolim
- Universidade Estadual de Campinas. Faculdade de Enfermagem. Campinas, São Paulo, Brasil
| | - Edilson Zancanella
- Universidade Estadual de Campinas. Faculdade de Ciências Médicas. Departamento de Oftalmologia/otorrinolaringologia. Campinas, São Paulo, Brasil
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20
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Madrid-Valero JJ, Ronald A, Shakeshaft N, Schofield K, Malanchini M, Gregory AM. Sleep quality, insomnia, and internalizing difficulties in adolescents: insights from a twin study. Sleep 2019; 43:5573767. [DOI: 10.1093/sleep/zsz229] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 07/11/2019] [Indexed: 11/14/2022] Open
Abstract
Abstract
Study Objectives
There is a well-established association between poor sleep quality and internalizing traits. This relationship has previously been studied using a twin design. However, when it comes to adolescence, there is a paucity of twin studies that have investigated this relationship, despite the importance of this developmental stage for both the development of poor sleep quality and internalizing symptoms. Additionally, anxiety sensitivity, which is commonly associated with poor sleep quality, has not been studied in this context. Our objective was to estimate genetic and environmental influences on the relationships between insomnia, poor sleep quality, and internalizing symptoms in adolescence.
Methods
Insomnia, poor sleep quality, depression, anxiety, and anxiety sensitivity traits were measured in a sample of 5111 twin pairs from the Twins Early Development Study, born between 1994 and 1996 (mean age 16.32 years [SD = 0.68]).
Results
A moderate proportion of the variance for the different variables (.29–.42) was explained by genetic factors. Associations between sleep and internalizing variables were moderate (r = .34–.46) and there was a large genetic overlap between these variables (rA= .51–.73).
Conclusion
This study adds novel information by showing that there are large genetic correlations between sleep disturbances and internalizing symptoms in adolescence.
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Affiliation(s)
- Juan J Madrid-Valero
- Department of Human Anatomy and Psychobiology, University of Murcia, Murcia, Spain
- Murcia Institute of Biomedical Research, IMIB-Arrixaca, Murcia, Spain
| | - Angelica Ronald
- Centre for Brain and Cognitive Development, Department of Psychological Sciences, Birkbeck University of London, London, UK
| | - Nicholas Shakeshaft
- MRC Social, Genetic, and Developmental Psychiatry Centre, King’s College London, London, UK
| | - Kerry Schofield
- MRC Social, Genetic, and Developmental Psychiatry Centre, King’s College London, London, UK
| | - Margherita Malanchini
- MRC Social, Genetic, and Developmental Psychiatry Centre, King’s College London, London, UK
- Department of Psychology, Queen Mary University of London, London, UK
| | - Alice M Gregory
- Department of Psychology, Goldsmiths, University of London, London, UK
- Department of Human Anatomy and Psychobiology, University of Murcia, Murcia, Spain
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21
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Ge L, Guyatt G, Tian J, Pan B, Chang Y, Chen Y, Li H, Zhang J, Li Y, Ling J, Yang K. Insomnia and risk of mortality from all-cause, cardiovascular disease, and cancer: Systematic review and meta-analysis of prospective cohort studies. Sleep Med Rev 2019; 48:101215. [PMID: 31630016 DOI: 10.1016/j.smrv.2019.101215] [Citation(s) in RCA: 100] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Revised: 09/05/2019] [Accepted: 09/10/2019] [Indexed: 12/15/2022]
Abstract
Growing evidence indicates that insomnia may be associated with mortality. However, these findings have been inconsistent. We systematically searched MEDLINE and EMBASE to identify prospective cohort studies that assessed the association between insomnia disorder/individual insomnia symptoms and the risk of mortality among adults aged ≥18 yrs. We addressed this association using summary hazard ratios (HRs) and 95% confidence intervals (CIs) calculated using random-effects meta-analysis, and the GRADE approach to rate the certainty of evidence. Twenty-nine cohorts including 1,598,628 individuals (55.3% men; mean age 63.7 yrs old) with a median follow-up duration of 10.5 yrs proved eligible. Difficulty falling asleep (DFA) and non-restorative sleep (NRS) were associated with an increased risk of all-cause mortality (DFA: HR = 1.13, 95%CI 1.03 to 1.23, p = 0.009, moderate certainty; NRS: HR = 1.23, 95%CI 1.07 to 1.42, p = 0.003, high certainty) and cardiovascular disease mortality (DFA: 1.20, 95%CI: 1.01, 1.43; p = 0.04, moderate certainty; NRS: HR = 1.48, 95%CI 1.06 to 2.06, p = 0.02, moderate certainty). Convincing associations between DFA and all-cause mortality were restricted to the mid to older-aged population (moderate credibility). Insomnia disorder, difficulty maintaining sleep, and early morning awakening proved to be unassociated with all-cause and cardiovascular disease mortality. No insomnia symptoms proved to be associated with cancer-related mortality.
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Affiliation(s)
- Long Ge
- Evidence Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, 730000, China; Evidence Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, 730000, China; Key Laboratory of Evidence-Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, 730000, China; Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, L8S 4L8, Canada; Department of Social Medicine and Health Management, School of Public Health, Lanzhou University, Lanzhou, 730000, China
| | - Gordon Guyatt
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, L8S 4L8, Canada
| | - Jinhui Tian
- Evidence Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, 730000, China; Key Laboratory of Evidence-Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, 730000, China
| | - Bei Pan
- Department of Social Medicine and Health Management, School of Public Health, Lanzhou University, Lanzhou, 730000, China
| | - Yaping Chang
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, L8S 4L8, Canada
| | - Yajing Chen
- Department of Social Medicine and Health Management, School of Public Health, Lanzhou University, Lanzhou, 730000, China
| | - Huijuan Li
- Department of Social Medicine and Health Management, School of Public Health, Lanzhou University, Lanzhou, 730000, China
| | - Junmei Zhang
- Department of Social Medicine and Health Management, School of Public Health, Lanzhou University, Lanzhou, 730000, China
| | - Yahong Li
- Department of Social Medicine and Health Management, School of Public Health, Lanzhou University, Lanzhou, 730000, China
| | - Juan Ling
- Evidence Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, 730000, China; Key Laboratory of Evidence-Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, 730000, China
| | - Kehu Yang
- Evidence Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, 730000, China; Evidence Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, 730000, China; Key Laboratory of Evidence-Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, 730000, China.
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22
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Xiang B, Liu K, Yu M, Liang X, Huang C, Zhang J, He W, Lei W, Chen J, Gu X, Gong K. Systematic genetic analyses of GWAS data reveal an association between the immune system and insomnia. Mol Genet Genomic Med 2019; 7:e00742. [PMID: 31094102 PMCID: PMC6625127 DOI: 10.1002/mgg3.742] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 04/18/2019] [Accepted: 04/22/2019] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Previous studies have inferred a strong genetic component for insomnia. However, the etiology of insomnia is still unclear. The aim of the current study was to explore potential biological pathways, gene networks, and brain regions associated with insomnia. METHODS Using pathways (gene sets) from Reactome, we carried out a two-stage gene set enrichment analysis strategy. From a large genome-wide association studies (GWASs) of insomnia symptoms (32,155 cases/26,973 controls), significant gene sets were tested for replication in other large GWASs of insomnia complaints (32,384 cases/80,622 controls). After the network analysis of unique genes within the replicated pathways, a gene set analysis for genes in each cluster/module of the enhancing neuroimaging genetics through meta-analysis GWAS data was performed for the volumes of the intracranial and seven subcortical regions. RESULTS A total of 31 of 1,816 Reactome pathways were identified and showed associations with insomnia risk. In addition, seven functionally and topologically interconnected clusters (clusters 0-6) and six gene modules (named Yellow, Blue, Brown, Green, Red, and Turquoise) were associated with insomnia. Moreover, significant associations were detected between common variants of the genes in Cluster 2 with hippocampal volume (p = 0.035; family wise error [FWE] correction) and the red module with intracranial volume (p = 0.047; FWE correction). Functional enrichment for genes in the Cluster 2 and the Red module revealed the involvement of immune responses, nervous system development, NIK/NF-kappaB signaling, and I-kappaB kinase/NF-kappaB signaling. Core genes (UBC, UBB, and UBA52) in the interconnected functional network were found to be involved in regulating brain development. CONCLUSIONS The current study demonstrates that the immune system and the hippocampus may play central roles in neurodevelopment and insomnia risk.
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Affiliation(s)
- Bo Xiang
- Department of Psychiatry, Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan ProvinceAffiliated Hospital of Southwest Medical UniversityLuzhouSichuan ProvinceChina
| | - Kezhi Liu
- Department of Psychiatry, Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan ProvinceAffiliated Hospital of Southwest Medical UniversityLuzhouSichuan ProvinceChina
| | - Minglan Yu
- Medical Laboratory CenterAffiliated Hospital of Southwest Medical UniversityLuzhouSichuan ProvinceChina
| | - Xuemei Liang
- Department of Psychiatry, Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan ProvinceAffiliated Hospital of Southwest Medical UniversityLuzhouSichuan ProvinceChina
| | - Chaohua Huang
- Department of Psychiatry, Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan ProvinceAffiliated Hospital of Southwest Medical UniversityLuzhouSichuan ProvinceChina
| | - Jin Zhang
- Department of Psychiatry, Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan ProvinceAffiliated Hospital of Southwest Medical UniversityLuzhouSichuan ProvinceChina
| | - Wenying He
- Department of Psychiatry, Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan ProvinceAffiliated Hospital of Southwest Medical UniversityLuzhouSichuan ProvinceChina
| | - Wei Lei
- Department of Psychiatry, Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan ProvinceAffiliated Hospital of Southwest Medical UniversityLuzhouSichuan ProvinceChina
| | - Jing Chen
- Department of Psychiatry, Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan ProvinceAffiliated Hospital of Southwest Medical UniversityLuzhouSichuan ProvinceChina
| | - Xiaochu Gu
- Clinical LaboratorySuzhou Guangji HospitalSuzhouJiangsu ProvinceChina
| | - Ke Gong
- Department of Psychiatry, Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan ProvinceAffiliated Hospital of Southwest Medical UniversityLuzhouSichuan ProvinceChina
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Brindle RC, Cribbet MR, Samuelsson LB, Gao C, Frank E, Krafty RT, Thayer JF, Buysse DJ, Hall MH. The Relationship Between Childhood Trauma and Poor Sleep Health in Adulthood. Psychosom Med 2019; 80:200-207. [PMID: 29215455 PMCID: PMC5794533 DOI: 10.1097/psy.0000000000000542] [Citation(s) in RCA: 80] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Childhood trauma has been related to adverse behavioral, mental, and health outcomes later in life. Sleep may be a potential mechanism through which childhood trauma is related to adverse health. The current retrospective study aimed to characterize the relationship between childhood trauma exposure and sleep health, a novel multidimensional measure of sleep. METHODS Participants (N = 161; mean [standard deviation] age = 59.85 [9.06] years; 67.7% female) retrospectively reported trauma exposure using the Trauma History Questionnaire. Childhood trauma was defined as the number of reported traumatic events before 18 years of age. Trauma exposure after 18 years of age and across the life-span was also recorded. Sleep health was derived both from diary- and actigraphy-assessed measures of sleep regularity, timing, efficiency, and duration, subjective sleep satisfaction, and daytime sleepiness from the Epworth Sleepiness Scale. The relationships between childhood trauma exposure and sleep health were examined using hierarchical linear regression, controlling for relevant covariates. RESULTS In unadjusted models, a greater number of childhood trauma exposures were associated with poorer diary- and actigraphy-measured sleep health in adulthood. After adjustment for current stress, depression history, and other sociodemographic covariates, greater childhood trauma remained significantly associated with poorer sleep health (diary: β = -0.20, ΔR = 0.032; actigraphy: β = -0.19, ΔR = 0.027). Trauma exposure after 18 years of age and across the life-span did not relate to diary- or actigraphy-based sleep health. CONCLUSIONS Childhood trauma may affect sleep health in adulthood. These findings align with the growing body of evidence linking childhood trauma to adverse health outcomes later in life.
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Affiliation(s)
| | | | | | - Chenlu Gao
- Department of Psychology and Neuroscience, Baylor University
| | - Ellen Frank
- Department of Psychiatry, University of Pittsburgh
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Palmberg L, Viljanen A, Rantanen T, Kaprio J, Rantakokko M. The Relationship Between Sleep Characteristics and Unmet Physical Activity Need in Older Women. J Aging Health 2018; 32:199-207. [PMID: 30466337 DOI: 10.1177/0898264318814021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Objective: We examined among older women the association of sleep quality, daytime tiredness, and sleep duration with unmet physical activity need, that is, wishing to be more physically active but perceiving no opportunity for it. Method: Cross-sectional logistic regression analyses among women aged 74 to 86 years (Finnish Twin Study on Aging, third wave, n = 302). Results: Thirty-one participants reported unmet physical activity need. Short sleepers had fivefold and long sleepers threefold odds for unmet physical activity need compared with normative sleepers, while for daytime tiredness the odds were double. Presence of daytime tiredness and unmet physical activity coincided with higher prevalence of chronic diseases, depressive symptoms and walking difficulties, which partly explains the observed associations. Poor sleep quality was not associated with unmet physical activity need. Discussion: Older women with nonoptimal sleep characteristics who perceive unmet physical activity need may benefit from solutions that improve their perceived opportunities for physical activity.
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Affiliation(s)
- Lotta Palmberg
- Gerontology Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, Finland
| | - Anne Viljanen
- Gerontology Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, Finland
| | - Taina Rantanen
- Gerontology Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, Finland
| | - Jaakko Kaprio
- Institute for Molecular Medicine Finland, Helsinki, Finland.,Department of Public Health, University of Helsinki, Finland
| | - Merja Rantakokko
- Gerontology Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, Finland
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Abstract
Insomnia is a worldwide problem with substantial deleterious health effects. Twin studies have shown a heritable basis for various sleep-related traits, including insomnia, but robust genetic risk variants have just recently begun to be identified. We conducted genome-wide association studies (GWAS) of soldiers in the Army Study To Assess Risk and Resilience in Servicemembers (STARRS). GWAS were carried out separately for each ancestral group (EUR, AFR, LAT) using logistic regression for each of the STARRS component studies (including 3,237 cases and 14,414 controls), and then meta-analysis was conducted across studies and ancestral groups. Heritability (SNP-based) for lifetime insomnia disorder was significant (h2g = 0.115, p = 1.78 × 10-4 in EUR). A meta-analysis including three ancestral groups and three study cohorts revealed a genome-wide significant locus on Chr 7 (q11.22) (top SNP rs186736700, OR = 0.607, p = 4.88 × 10-9) and a genome-wide significant gene-based association (p = 7.61 × 10-7) in EUR for RFX3 on Chr 9. Polygenic risk for sleeplessness/insomnia severity in UK Biobank was significantly positively associated with likelihood of insomnia disorder in STARRS. Genetic contributions to insomnia disorder in STARRS were significantly positively correlated with major depressive disorder (rg = 0.44, se = 0.22, p = 0.047) and type 2 diabetes (rg = 0.43, se = 0.20, p = 0.037), and negatively with morningness chronotype (rg = -0.34, se = 0.17, p = 0.039) and subjective well being (rg = -0.59, se = 0.23, p = 0.009) in external datasets. Insomnia associated loci may contribute to the genetic risk underlying a range of health conditions including psychiatric disorders and metabolic disease.
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Kallestad H, Vedaa Ø, Scott J, Morken G, Pallesen S, Harvey AG, Gehrman P, Thorndike F, Ritterband L, Stiles TC, Sivertsen B. Overcoming insomnia: protocol for a large-scale randomised controlled trial of online cognitive behaviour therapy for insomnia compared with online patient education about sleep. BMJ Open 2018; 8:e025152. [PMID: 30166311 PMCID: PMC6119451 DOI: 10.1136/bmjopen-2018-025152] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Revised: 07/29/2018] [Accepted: 07/31/2018] [Indexed: 01/21/2023] Open
Abstract
INTRODUCTION Insomnia is a major public health concern. While cognitive behaviour therapy for insomnia (CBT-I) is acknowledged as the best available intervention, there are unanswered questions about its wider dissemination, socioeconomic benefits and its impact on health resource utilisation. The aim of this randomised controlled trial (RCT) is to investigate the effectiveness of a fully automated online version of CBT-I compared with online patient education about sleep (PE). Outcome measures comprise changes in symptoms of insomnia, time off work due to sick leave as well as medication and health resource utilisation. Also, we will examine (i) putative mediators of the effects of CBT-I on insomnia severity and (ii) selected potential psycho-bio-social moderators of the effects of the interventions. METHODS AND ANALYSIS A parallel-group RCT will be conducted in a target sample of about 1500 adults recruited across Norway. Participants will complete an online screening and consent process. Those who meet eligibility criteria will be randomised to receive direct access to fully automated online CBT-I or to an online PE programme. The primary outcome is change in insomnia severity immediately postintervention; secondary outcomes are change in daytime functioning and other sleep measures postintervention and at 6-month and 24-month follow-up. Objective data from national registries will be obtained at two time points (1 year and 2 years post-treatment), allowing a mirror image study of preintervention and postintervention rates of sick leave, and of medication and healthcare utilisation by condition. ETHICS AND DISSEMINATION The study protocol was approved by the Regional Committee for Medical and Health Research Ethics in South East Norway (2015/134). Findings from the RCT will be disseminated in peer-reviewed publications and conference presentations. Exploratory analyses of potential mediators and moderators will be reported separately. User-friendly outputs will be disseminated to patient advocacy and other relevant organisations. TRIAL REGISTRATION NUMBER NCT02558647; Pre-results.
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Affiliation(s)
- Håvard Kallestad
- Department of Research and Development, St. Olavs University Hospital, Trondheim, Norway
- Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway
| | - Øystein Vedaa
- Department of Research and Development, St. Olavs University Hospital, Trondheim, Norway
- Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway
| | - Jan Scott
- Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway
- Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
| | - Gunnar Morken
- Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Mental Health Care, St. Olavs University Hospital, Trondheim, Norway
| | - Ståle Pallesen
- Department of Psychosocial Science, Faculty of Psychology, University of Bergen, Bergen, Norway
| | - Allison G Harvey
- Department of Psychology, University of California Berkeley, Berkeley, California, USA
| | - Phil Gehrman
- Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | | | - Lee Ritterband
- Department of Psychiatry and Neurobehavioral Sciences, University of Virginia, Charlottesville, Virginia, USA
| | - Tore Charles Stiles
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
| | - Børge Sivertsen
- Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway
- Department of Research and Innovation, Helse-Fonna HF, Haugesund, Norway
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A meta-analysis of associations between obesity and insomnia diagnosis and symptoms. Sleep Med Rev 2018; 40:170-182. [DOI: 10.1016/j.smrv.2017.12.004] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Revised: 10/12/2017] [Accepted: 12/11/2017] [Indexed: 12/15/2022]
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Madrid-Valero JJ, Sánchez-Romera JF, Gregory AM, Martínez-Selva JM, Ordoñana JR. Heritability of sleep quality in a middle-aged twin sample from Spain. Sleep 2018; 41:5003439. [DOI: 10.1093/sleep/zsy110] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Indexed: 11/13/2022] Open
Affiliation(s)
- Juan J Madrid-Valero
- Department of Human Anatomy and Psychobiology, University of Murcia, Spain
- Murcia Institute of Biomedical Research, IMIB-Arrixaca, Spain
| | - Juan F Sánchez-Romera
- Department of Human Anatomy and Psychobiology, University of Murcia, Spain
- Murcia Institute of Biomedical Research, IMIB-Arrixaca, Spain
| | - Alice M Gregory
- Department of Psychology, Goldsmiths, University of London, UK
| | - José M Martínez-Selva
- Department of Human Anatomy and Psychobiology, University of Murcia, Spain
- Murcia Institute of Biomedical Research, IMIB-Arrixaca, Spain
| | - Juan R Ordoñana
- Department of Human Anatomy and Psychobiology, University of Murcia, Spain
- Murcia Institute of Biomedical Research, IMIB-Arrixaca, Spain
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Genetic and Environmental Contributions to Sleep Quality and Low Back Pain: A Population-Based Twin Study. Psychosom Med 2018; 80:263-270. [PMID: 29240646 DOI: 10.1097/psy.0000000000000548] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The aim of the study was to estimate the extent to which the co-occurrence of poor sleep quality and low back pain is due to the same genetic and/or environmental risk factors or due to a causal association. METHODS Cross-sectional data on sleep quality (Pittsburgh Sleep Quality index) and low back pain were collected in a population-based sample of adult twins (N = 2134) registered with the Murcia Twin Registry. Bivariate analysis and structural equation modeling were used. RESULTS The phenotypic correlation between sleep quality and low back pain was 0.23 (95% confidence interval [CI] = 0.17-0.28). The best-fitting bivariate model included additive genetic and unique environmental factors. Genetic factors accounted for 26% (95% CI = 10-40) and 34% (95% CI = 25-43) of the variability of low back pain and sleep quality, respectively. The correlation between the genetic factors underlying each trait was rG of 0.33 (95% CI = 0.03-0.66), and this overlap of genetic factors explained 42.5% of the phenotypic correlation. On the other hand, nonshared environmental factors of each variable were only fairly correlated rE of 0.19 (95% CI = 0.06-0.31), although this overlap explained 57.5% of the phenotypic correlation. In addition, twins in monozygotic pairs with poorer sleep quality presented more often with low back pain than their co-twins (ρ^ = 0.25, p < .0001). CONCLUSIONS The data are compatible with a causal effect of sleep quality on low back pain (or the reverse effect), because the correlations between the genetic and unique environmental factors for each trait were significant and there was a significant correlation between the monozygotic twins' difference scores. Apart from environmental factors that affect both characteristics, there are many individual-specific events that influence low back pain but differ from those influencing sleep quality.
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Sun J, An L, Zhang Z, Zhao N, Yuan G, Du P. Extraction methods and sedative–hypnotic effects of polysaccharide and total flavonoids of Cordyceps militaris. BIOTECHNOL BIOTEC EQ 2018. [DOI: 10.1080/13102818.2017.1336942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Affiliation(s)
- Jingbo Sun
- Laboratory of Medicinal Chemistry, Department of Pharmacy, Pharmaceutical College, Beihua University, Jilin, P.R. China
| | - Liping An
- Laboratory of Medicinal Chemistry, Department of Pharmacy, Pharmaceutical College, Beihua University, Jilin, P.R. China
| | - Zexu Zhang
- Laboratory of Medicinal Chemistry, Department of Pharmacy, Pharmaceutical College, Beihua University, Jilin, P.R. China
| | - Nanxi Zhao
- Laboratory of Medicinal Chemistry, Department of Pharmacy, Pharmaceutical College, Beihua University, Jilin, P.R. China
| | - Guangxin Yuan
- Laboratory of Medicinal Chemistry, Department of Pharmacy, Pharmaceutical College, Beihua University, Jilin, P.R. China
| | - Peige Du
- Laboratory of Medicinal Chemistry, Department of Pharmacy, Pharmaceutical College, Beihua University, Jilin, P.R. China
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Gan-Or Z, Alcalay RN, Rouleau GA, Postuma RB. Sleep disorders and Parkinson disease; lessons from genetics. Sleep Med Rev 2018; 41:101-112. [PMID: 29449121 DOI: 10.1016/j.smrv.2018.01.006] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Revised: 10/04/2017] [Accepted: 01/15/2018] [Indexed: 02/08/2023]
Abstract
Parkinson disease is a common, age-related neurodegenerative disorder, projected to afflict millions of individuals in the near future. Understanding its etiology and identifying clinical, genetic or biological markers for Parkinson disease onset and progression is therefore of major importance. Various sleep-related disorders are the most common group of non-motor symptoms in advanced Parkinson disease, but they can also occur during its prodromal phase. However, with the exception of REM sleep behavior disorder, it is unclear whether they are part of the early pathological process of Parkinson disease, or if they develop as Parkinson disease advances because of treatments and neurodegeneration progression. The advancements in genetic studies in the past two decades have generated a wealth of information, and recent genetic studies offer new insight on the association of sleep-related disorders with Parkinson disease. More specifically, comparing genetic data between Parkinson disease and sleep-related disorders can clarify their association, which may assist in determining whether they can serve as clinical markers for Parkinson disease risk or progression. In this review, we discuss the current knowledge on the genetics of sleep-related disorders in Parkinson disease context, and the potential implications on research, diagnosis, counseling and treatment.
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Affiliation(s)
- Ziv Gan-Or
- Montreal Neurological Institute, McGill University, Montréal, QC, Canada; Department of Human Genetics, McGill University, Montréal, QC, Canada; Department of Neurology and Neurosurgery, McGill University, Montréal, QC, Canada.
| | - Roy N Alcalay
- Department of Neurology, Taub Institute for Research on Alzheimer's Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Guy A Rouleau
- Montreal Neurological Institute, McGill University, Montréal, QC, Canada; Department of Human Genetics, McGill University, Montréal, QC, Canada; Department of Neurology and Neurosurgery, McGill University, Montréal, QC, Canada
| | - Ronald B Postuma
- Department of Neurology and Neurosurgery, McGill University, Montréal, QC, Canada
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Hublin C, Lehtovirta M, Partinen M, Koskenvuo M, Kaprio J. Changes in sleep quality with age-a 36-year follow-up study of Finnish working-aged adults. J Sleep Res 2017; 27:e12623. [DOI: 10.1111/jsr.12623] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Accepted: 09/14/2017] [Indexed: 02/01/2023]
Affiliation(s)
- Christer Hublin
- Finnish Institute of Occupational Health; Helsinki Finland
- Department of Public Health; University of Helsinki; Helsinki Finland
| | - Mikko Lehtovirta
- Institute for Molecular Medicine Finland FIMM; University of Helsinki; Helsinki Finland
| | - Markku Partinen
- Department of Public Health; University of Helsinki; Helsinki Finland
- Helsinki Sleep Clinic; Vitalmed Research Centre; Helsinki Finland
| | - Markku Koskenvuo
- Department of Public Health; University of Helsinki; Helsinki Finland
| | - Jaakko Kaprio
- Department of Public Health; University of Helsinki; Helsinki Finland
- Institute for Molecular Medicine Finland FIMM; University of Helsinki; Helsinki Finland
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Rogers LQ, Courneya KS, Oster RA, Anton PM, Robbs RS, Forero A, McAuley E. Physical Activity and Sleep Quality in Breast Cancer Survivors: A Randomized Trial. Med Sci Sports Exerc 2017; 49:2009-2015. [PMID: 28538261 PMCID: PMC5600650 DOI: 10.1249/mss.0000000000001327] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
PURPOSE Data from large randomized controlled trials confirming sleep quality improvements with aerobic physical activity have heretofore been lacking for post-primary treatment breast cancer survivors. Our primary purpose for this report was to determine the effects of a physical activity behavior change intervention, previously reported to significantly increase physical activity behavior, on sleep quality in post-primary treatment breast cancer survivors. METHODS Post-primary treatment breast cancer survivors (n = 222) were randomized to a 3-month physical activity behavior change intervention (Better Exercise Adherence after Treatment for Cancer [BEAT Cancer]) or usual care. Self-report (Pittsburgh Sleep Quality Index [PSQI]) and actigraphy (latency and efficiency) sleep outcomes were measured at baseline, 3 months (M3), and 6 months (M6). RESULTS After adjusting for covariates, BEAT Cancer significantly improved PSQI global sleep quality when compared with usual care at M3 (mean between-group difference [M] = -1.4, 95% confidence interval [CI] = -2.1 to -0.7, P < 0.001) and M6 (M = -1.0, 95% CI = -1.7 to -0.2, P = 0.01). BEAT Cancer improved several PSQI subscales at M3 (sleep quality M = -0.3, 95% CI = -0.4 to -0.1, P = 0.002; sleep disturbances M = -0.2, 95% CI = -0.3 to -0.03, P = 0.016; daytime dysfunction M = -0.2, 95% CI = -0.4 to -0.02, P = 0.027) but not M6. A nonsignificant increase in percent of participants classified as good sleepers occurred. No significant between-group difference was noted for accelerometer latency or efficiency. CONCLUSION A physical activity intervention significantly reduced perceived global sleep dysfunction at 3 and 6 months, primarily because of improvements in sleep quality aspects not detected with accelerometer.
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Affiliation(s)
- Laura Q. Rogers
- Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, AL
| | - Kerry S. Courneya
- Faculty of Physical Education and Recreation, University of Alberta, Edmonton, Alberta, Canada
| | - Robert A. Oster
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL
| | - Philip M. Anton
- Department of Kinesiology, Southern Illinois University Carbondale, Carbondale, IL
| | - Randall S. Robbs
- Statistics and Research Informatics Core, Center for Clinical Research, Southern Illinois University School of Medicine, Springfield, IL
| | - Andres Forero
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL
| | - Edward McAuley
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, IL
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Lind MJ, Gehrman PR. Genetic Pathways to Insomnia. Brain Sci 2016; 6:E64. [PMID: 27999387 PMCID: PMC5187578 DOI: 10.3390/brainsci6040064] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Revised: 12/14/2016] [Accepted: 12/16/2016] [Indexed: 01/10/2023] Open
Abstract
This review summarizes current research on the genetics of insomnia, as genetic contributions are thought to be important for insomnia etiology. We begin by providing an overview of genetic methods (both quantitative and measured gene), followed by a discussion of the insomnia genetics literature with regard to each of the following common methodologies: twin and family studies, candidate gene studies, and genome-wide association studies (GWAS). Next, we summarize the most recent gene identification efforts (primarily GWAS results) and propose several potential mechanisms through which identified genes may contribute to the disorder. Finally, we discuss new genetic approaches and how these may prove useful for insomnia, proposing an agenda for future insomnia genetics research.
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Affiliation(s)
- Mackenzie J Lind
- Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA 23298, USA.
| | - Philip R Gehrman
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.
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Jarrin DC, Morin CM, Rochefort A, Ivers H, Dauvilliers YA, Savard J, LeBlanc M, Merette C. Familial Aggregation of Insomnia. Sleep 2016; 40:2666710. [DOI: 10.1093/sleep/zsw053] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Gamaldo AA, Beydoun MA, Beydoun HA, Liang H, Salas RE, Zonderman AB, Gamaldo CE, Eid SM. Sleep Disturbances among Older Adults in the United States, 2002-2012: Nationwide Inpatient Rates, Predictors, and Outcomes. Front Aging Neurosci 2016; 8:266. [PMID: 27895576 PMCID: PMC5109617 DOI: 10.3389/fnagi.2016.00266] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Accepted: 10/24/2016] [Indexed: 01/08/2023] Open
Abstract
Objective/Background: We examined the rates, predictors, and outcomes [mortality risk (MR), length of stay (LOS), and total charges (TC)] of sleep disturbances in older hospitalized patients. Patients/Methods: Using the U.S. Nationwide Inpatient Sample database (2002–2012), older patients (≥60 years) were selected and rates of insomnia, obstructive sleep apnea (OSA) and other sleep disturbances (OSD) were estimated using ICD-9CM. TC, adjusted for inflation, was of primary interest, while MR and LOS were secondary outcomes. Multivariable regression analyses were conducted. Results: Of 35,258,031 older adults, 263,865 (0.75%) had insomnia, 750,851 (2.13%) OSA and 21,814 (0.06%) OSD. Insomnia rates increased significantly (0.27% in 2002 to 1.29 in 2012, P-trend < 0.001), with a similar trend observed for OSA (1.47 in 2006 to 5.01 in 2012, P-trend < 0.001). TC (2012 $) for insomnia-related hospital admission increased over time from $22,250 in 2002 to $31,527 in 2012, and increased similarly for OSA and OSD; while LOS and MR both decreased. Women with any sleep disturbance had lower MR and TC than men, while Whites had consistently higher odds of insomnia, OSA, and OSD than older Blacks and Hispanics. Co-morbidities such as depression, cardiovascular risk factors, and neurological disorders steadily increased over time in patients with sleep disturbances. Conclusion: TC increased over time in patients with sleep disturbances while LOS and MR decreased. Further, research should focus on identifying the mechanisms that explain the association between increasing sleep disturbance rates and expenditures within hospital settings and the potential hospital expenditures of unrecognized sleep disturbances in the elderly.
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Affiliation(s)
- Alyssa A Gamaldo
- School of Aging Studies, University of South FloridaTampa, FL, USA; Behavioral Epidemiology Section, Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIA/NIH/IRPBaltimore, MD, USA; Human Development and Family Studies, Penn State UniversityState College, PA, USA
| | - May A Beydoun
- Behavioral Epidemiology Section, Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIA/NIH/IRP Baltimore, MD, USA
| | - Hind A Beydoun
- Department of Medicine, Johns Hopkins University School of Medicine Baltimore, MD, USA
| | - Hailun Liang
- Department of Health Policy and Management, Johns Hopkins University Bloomberg School of Public Health Baltimore, MD, USA
| | - Rachel E Salas
- Department of Neurology, Johns Hopkins University School of Medicine Baltimore, MD, USA
| | - Alan B Zonderman
- Behavioral Epidemiology Section, Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIA/NIH/IRP Baltimore, MD, USA
| | - Charlene E Gamaldo
- Department of Neurology, Johns Hopkins University School of Medicine Baltimore, MD, USA
| | - Shaker M Eid
- Department of Medicine, Johns Hopkins University School of Medicine Baltimore, MD, USA
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Lallukka T, Podlipskytė A, Sivertsen B, Andruškienė J, Varoneckas G, Lahelma E, Ursin R, Tell GS, Rahkonen O. Insomnia symptoms and mortality: a register-linked study among women and men from Finland, Norway and Lithuania. J Sleep Res 2016; 25:96-103. [PMID: 26420582 DOI: 10.1111/jsr.12343] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2015] [Accepted: 08/13/2015] [Indexed: 11/26/2022]
Abstract
Evidence on the association between insomnia symptoms and mortality is limited and inconsistent. This study examined the association between insomnia symptoms and mortality in cohorts from three countries to show common and unique patterns. The Finnish cohort comprised 6605 employees of the City of Helsinki, aged 40-60 years at baseline in 2000-2002. The Norwegian cohort included 6236 participants from Western Norway, aged 40-45 years at baseline in 1997-1999. The Lithuanian cohort comprised 1602 participants from the City of Palanga, aged 35-74 years at baseline in 2003. Mortality data were derived from the Statistics Finland and Norwegian Cause of Death Registry until the end of 2012, and from the Lithuanian Regional Mortality Register until the end of 2013. Insomnia symptoms comprised difficulties initiating sleep, nocturnal awakenings, and waking up too early. Covariates were age, marital status, education, smoking, alcohol, physical inactivity, obesity, diabetes, cardiovascular diseases, depression, shift work, sleep duration, and self-rated health. Cox regression analysis was used. Frequent difficulties initiating sleep were associated with all-cause mortality among men after full adjustments in the Finnish (hazard ratio 2.51; 95% confidence interval 1.07-5.88) and Norwegian (hazard ratio 3.42; 95% confidence interval 1.03-11.35) cohorts. Among women and in Lithuania, insomnia symptoms were not statistically significantly associated with all-cause mortality after adjustments. In conclusion, difficulties initiating sleep were associated with mortality among Norwegian and Finnish men. Variation and heterogeneity in the association between insomnia symptoms and mortality highlights that further research needs to distinguish between men and women, specific symptoms and national contexts, and focus on more chronic insomnia.
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Abstract
Sleeping pills, more formally defined as hypnotics, are sedatives used to induce and maintain sleep. In a review of publications for the past 30 years, descriptive epidemiologic studies were identified that examined the mortality risk of hypnotics and related sedative-anxiolytics. Of the 34 studies estimating risk ratios, odds ratios, or hazard ratios, excess mortality associated with hypnotics was significant (p < 0.05) in 24 studies including all 14 of the largest, contrasted with no studies at all suggesting that hypnotics ever prolong life. The studies had many limitations: possibly tending to overestimate risk, such as possible confounding by indication with other risk factors; confusing hypnotics with drugs having other indications; possible genetic confounders; and too much heterogeneity of studies for meta-analyses. There were balancing limitations possibly tending towards underestimates of risk such as limited power, excessive follow-up intervals with possible follow-up mixing of participants taking hypnotics with controls, missing dosage data for most studies, and over-adjustment of confounders. Epidemiologic association in itself is not adequate proof of causality, but there is proof that hypnotics cause death in overdoses; there is thorough understanding of how hypnotics euthanize animals and execute humans; and there is proof that hypnotics cause potentially lethal morbidities such as depression, infection, poor driving, suppressed respiration, and possibly cancer. Combining these proofs with consistent evidence of association, the great weight of evidence is that hypnotics cause huge risks of decreasing a patient's duration of survival.
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Affiliation(s)
- Daniel F Kripke
- UCSD, 8437 Sugarman Drive, La Jolla, CA, 92037-2226, USA. .,Scripps Clinic Viterbi Family Sleep Center, La Jolla, USA.
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Kapella MC, Herdegen JJ, Laghi F, Steffen AD, Carley DW. Efficacy and mechanisms of behavioral therapy components for insomnia coexisting with chronic obstructive pulmonary disease: study protocol for a randomized controlled trial. Trials 2016; 17:258. [PMID: 27215949 PMCID: PMC4878045 DOI: 10.1186/s13063-016-1334-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2015] [Accepted: 04/08/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Difficulty falling asleep, staying asleep or poor-quality sleep (insomnia) is common in people with chronic obstructive pulmonary disease (COPD). Insomnia is related to greater mortality and morbidity, with four times the risk of mortality for sleep times below 300 min. However, insomnia medications are used with caution in COPD due to their potential adverse effects. While cognitive behavioral therapy for insomnia (CBT-I) is effective for people with primary insomnia and people with other chronic illnesses, the efficacy and mechanisms of action of such a therapy are yet unclear in people with both insomnia and COPD. The purpose of this study is to rigorously test the efficacy of two components of insomnia therapy - CBT-I and COPD education (COPD-ED) - in people with coexisting insomnia and COPD, and to identify mechanisms responsible for therapy outcomes. The rationale for the proposed study is that once the efficacy and mechanisms of CBT-I and COPD-ED are known, new and innovative approaches for insomnia coexisting with COPD can be developed to non-pharmacologically minimize insomnia and fatigue, thereby leading to longer, higher-quality and more productive lives for people with COPD, and reduced societal cost due to the effects of insomnia. METHODS We are conducting a randomized, controlled, parallel-group (N = 35 each group) comparison of CBT-I, COPD-ED and non-COPD, non-sleep health education Attention Control (AC) using a highly efficient four-group design. Arm 1 comprises 6 weekly sessions of CBT-I + AC; Arm 2 = 6 weekly sessions of COPD-ED + AC; Arm 3 = 6 weekly sessions of CBT-I + COPD-ED; and Arm 4 = 6 weekly sessions of AC. This design will allow completion of the following specific aims: (1) to determine the efficacy of individual treatment components, CBT-I and COPD-ED, on insomnia and fatigue, (2) to define the mechanistic contributors to the outcomes after CBT-I and COPD-ED. DISCUSSION The research is innovative because it represents a new and substantive departure from the usual insomnia therapy, namely by testing traditional CBT-I with education to enhance outcomes. The work proposed in aims 1 and 2 will provide systematic evidence of the efficacy and mechanisms of components of a novel approach to insomnia comorbid with COPD. Such results are highly likely to provide new approaches for preventive and therapeutic interventions for insomnia and fatigue in COPD. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT01973647 . Registered on 22 October 2013.
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Affiliation(s)
- Mary C. Kapella
- />Department of Biobehavioral Health Science, College of Nursing, University of Illinois at Chicago, Chicago, USA
- />UIC Center for Narcolepsy, Sleep and Health Research, Chicago, USA
| | | | - Franco Laghi
- />Edward Hines, Jr. Department of Veterans Affairs Hospital, Hines, IL USA
- />Division of Pulmonary and Critical Care, Medicine, Loyola University Stritch School of Medicine, Maywood, IL USA
| | - Alana D. Steffen
- />Department of Health Systems Science, College of Nursing, University of Illinois at Chicago, Chicago, IL USA
| | - David W. Carley
- />Department of Biobehavioral Health Science, College of Nursing, University of Illinois at Chicago, Chicago, USA
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Tuomilehto H, Vuorinen VP, Penttilä E, Kivimäki M, Vuorenmaa M, Venojärvi M, Airaksinen O, Pihlajamäki J. Sleep of professional athletes: Underexploited potential to improve health and performance. J Sports Sci 2016; 35:704-710. [DOI: 10.1080/02640414.2016.1184300] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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Markkula RA, Kalso EA, Kaprio JA. Predictors of fibromyalgia: a population-based twin cohort study. BMC Musculoskelet Disord 2016; 17:29. [PMID: 26772544 PMCID: PMC4715288 DOI: 10.1186/s12891-016-0873-6] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Accepted: 01/05/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Fibromyalgia (FM) is a pain syndrome, the mechanisms and predictors of which are still unclear. We have earlier validated a set of FM-symptom questions for detecting possible FM in an epidemiological survey and thereby identified a cluster with "possible FM". This study explores prospectively predictors for membership of that FM-symptom cluster. METHODS A population-based sample of 8343 subjects of the older Finnish Twin Cohort replied to health questionnaires in 1975, 1981, and 1990. Their answers to the set of FM-symptom questions in 1990 classified them in three latent classes (LC): LC1 with no or few symptoms, LC2 with some symptoms, and LC3 with many FM symptoms. We analysed putative predictors for these symptom classes using baseline (1975 and 1981) data on regional pain, headache, migraine, sleeping, body mass index (BMI), physical activity, smoking, and zygosity, adjusted for age, gender, and education. Those with a high likelihood of having fibromyalgia at baseline were excluded from the analysis. In the final multivariate regression model, regional pain, sleeping problems, and overweight were all predictors for membership in the class with many FM symptoms. RESULTS The strongest non-genetic predictor was frequent headache (OR 8.6, CI 95% 3.8-19.2), followed by persistent back pain (OR 4.7, CI 95% 3.3-6.7) and persistent neck pain (OR 3.3, CI 95% 1.8-6.0). CONCLUSIONS Regional pain, frequent headache, and persistent back or neck pain, sleeping problems, and overweight are predictors for having a cluster of symptoms consistent with fibromyalgia.
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Affiliation(s)
- Ritva A Markkula
- Anaesthesiology, Intensive Care and Pain Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
| | - Eija A Kalso
- Anaesthesiology, Intensive Care and Pain Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Jaakko A Kaprio
- Department of Public Health, Hjelt Institute, University of Helsinki, Helsinki, Finland.,Institute for Molecular Medicine, University of Helsinki, Helsinki, Finland.,Department of Mental Health and Alcohol Abuse Services, National Institute for Health and Welfare, Helsinki, Finland
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Asnis GM, Thomas M, Henderson MA. Pharmacotherapy Treatment Options for Insomnia: A Primer for Clinicians. Int J Mol Sci 2015; 17:ijms17010050. [PMID: 26729104 PMCID: PMC4730295 DOI: 10.3390/ijms17010050] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2015] [Revised: 12/22/2015] [Accepted: 12/22/2015] [Indexed: 01/08/2023] Open
Abstract
Insomnia is a prevalent disorder with deleterious effects such as decreased quality of life, and a predisposition to a number of psychiatric disorders. Fortunately, numerous approved hypnotic treatments are available. This report reviews the state of the art of pharmacotherapy with a reference to cognitive behavioral therapy for insomnia (CBT-I) as well. It provides the clinician with a guide to all the Food and Drug Administration (FDA) approved hypnotics (benzodiazepines, nonbenzodiazepines, ramelteon, low dose sinequan, and suvorexant) including potential side effects. Frequently, chronic insomnia lasts longer than 2 years. Cognizant of this and as a result of longer-term studies, the FDA has approved all hypnotics since 2005 without restricting the duration of use. Our manuscript also reviews off-label hypnotics (sedating antidepressants, atypical antipsychotics, anticonvulsants and antihistamines) which in reality, are more often prescribed than approved hypnotics. The choice of which hypnotic to choose is discussed partially being based on which segment of sleep is disturbed and whether co-morbid illnesses exist. Lastly, we discuss recent label changes required by the FDA inserting a warning about “sleep-related complex behaviors”, e.g., sleep-driving for all hypnotics. In addition, we discuss FDA mandated dose reductions for most zolpidem preparations in women due to high zolpidem levels in the morning hours potentially causing daytime carry-over effects.
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Affiliation(s)
- Gregory M Asnis
- Albert Einstein College of Medicine/Montefiore Medical Center, Department of Psychiatry & Behavioral Science, Bronx, NY 10467, USA.
- The Anxiety and Depression Clinic, Bronx, NY 10570, USA.
| | - Manju Thomas
- The Anxiety and Depression Clinic, Bronx, NY 10570, USA.
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Hublin C, Lehtovirta M, Partinen M, Koskenvuo M, Kaprio J. Napping and the risk of type 2 diabetes: a population-based prospective study. Sleep Med 2015; 17:144-8. [PMID: 26847990 DOI: 10.1016/j.sleep.2015.11.004] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2015] [Revised: 10/27/2015] [Accepted: 11/02/2015] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Some studies indicate an association between napping and increased risk of type 2 diabetes. We studied this prospectively in a sample representative of general population. METHODS A questionnaire was administered to the Finnish Twin Cohort in 1990 (response rate 77%, age 33-60 years). The study population included 12,244 subjects who replied to the question "Do you sleep during the daytime (take naps)?" with five response alternatives ranging from "no need" to "every or almost every day." Information on incident cases of diabetes was obtained by linkage to nationwide registers. Logistic regression models were used to obtain odds ratios (ORs) (95% confidence intervals) for incident type 2 diabetes risk in 1991-2004 by napping category. Adjustments were made for 11 socio-demographic and lifestyle covariates. For subjects aged 33-45 years at baseline, a questionnaire in 2011 provided information on prevalent diabetes. RESULTS Thirty-four per cent had no need for napping, and 15% did so on ≥3 days weekly. There were 356 incident type 2 diabetes cases during the follow-up. Using the 'no need' category as the reference, the risk of type 2 diabetes was significantly increased only among those napping most frequently [OR 1.86 (1.29-2.67), age- and sex-adjusted]. After adjusting for other covariates, the results were essentially the same, but when adjusted for body mass index, the association decreased (to about 1.3) and was statistically non-significant. Analysis of 2011 self-reported type 2 diabetes was in line with the register data. CONCLUSIONS Frequent napping is associated with future risk of type 2 diabetes. This association is largely explained by obesity.
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Affiliation(s)
- Christer Hublin
- Finnish Institute of Occupational Health, Helsinki, Finland; Department of Public Health, University of Helsinki, Helsinki, Finland.
| | - Mikko Lehtovirta
- Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland
| | - Markku Partinen
- Department of Public Health, University of Helsinki, Helsinki, Finland; Helsinki Sleep Clinic, Vitalmed Research Centre, Helsinki, Finland
| | - Markku Koskenvuo
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Jaakko Kaprio
- Department of Public Health, University of Helsinki, Helsinki, Finland; Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland; National Institute for Health and Welfare, Helsinki, Finland
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Morin CM, Drake CL, Harvey AG, Krystal AD, Manber R, Riemann D, Spiegelhalder K. Insomnia disorder. Nat Rev Dis Primers 2015; 1:15026. [PMID: 27189779 DOI: 10.1038/nrdp.2015.26] [Citation(s) in RCA: 342] [Impact Index Per Article: 38.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Insomnia disorder affects a large proportion of the population on a situational, recurrent or chronic basis and is among the most common complaints in medical practice. The disorder is predominantly characterized by dissatisfaction with sleep duration or quality and difficulties initiating or maintaining sleep, along with substantial distress and impairments of daytime functioning. It can present as the chief complaint or, more often, co-occurs with other medical or psychiatric disorders, such as pain and depression. Persistent insomnia has been linked with adverse long-term health outcomes, including diminished quality of life and physical and psychological morbidity. Despite its high prevalence and burden, the aetiology and pathophysiology of insomnia is poorly understood. In the past decade, important changes in classification and diagnostic paradigms have instigated a move from a purely symptom-based conceptualization to the recognition of insomnia as a disorder in its own right. These changes have been paralleled by key advances in therapy, with generic pharmacological and psychological interventions being increasingly replaced by approaches that have sleep-specific and insomnia-specific therapeutic targets. Psychological and pharmacological therapies effectively reduce the time it takes to fall asleep and the time spent awake after sleep onset, and produce a modest increase in total sleep time; these are outcomes that correlate with improvements in daytime functioning. Despite this progress, several challenges remain, including the need to improve our knowledge of the mechanisms that underlie insomnia and to develop more cost-effective, efficient and accessible therapies.
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Affiliation(s)
- Charles M Morin
- Université Laval, École de psychologie, 2325 rue des Bibliothèques, Québec City, Québec G1V 0A6, Canada
| | - Christopher L Drake
- Henry Ford Hospital Sleep Disorders and Research Center, Detroit, Michigan, USA
| | - Allison G Harvey
- Department of Psychology, University of California, Berkeley, Berkeley, California, USA
| | - Andrew D Krystal
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina, USA
| | - Rachel Manber
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California, USA
| | - Dieter Riemann
- Department of Clinical Psychology and Psychophysiology/Sleep Medicine, Center for Mental Disorders, University of Freiburg Medical Center, Freiburg, Germany
| | - Kai Spiegelhalder
- Department of Clinical Psychology and Psychophysiology/Sleep Medicine, Center for Mental Disorders, University of Freiburg Medical Center, Freiburg, Germany
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Lind MJ, Aggen SH, Kirkpatrick RM, Kendler KS, Amstadter AB. A Longitudinal Twin Study of Insomnia Symptoms in Adults. Sleep 2015; 38:1423-30. [PMID: 26132482 PMCID: PMC4531410 DOI: 10.5665/sleep.4982] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2014] [Accepted: 03/07/2015] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE Twin modeling was used to conduct a genetically informative longitudinal analysis of insomnia symptoms in both sexes. METHOD Data from the Virginia Adult Twin Studies of Psychiatric and Substance Use Disorders (n = 7,500) were used. Past-month insomnia symptoms were assessed at two time points with the shortened version of the Symptom Checklist-90. A composite score for the insomnia items (trouble falling asleep, restless or disturbed sleep, early morning awakenings) was computed. Twin modeling on the composite score was conducted in OpenMx to decompose the phenotypic variance, to examine the longitudinal stability of etiologic influences on insomnia symptoms, and to test for sex differences. RESULTS Insomnia symptoms were most commonly endorsed at a mild severity level (composite score mean = 2.24, standard deviation = 2.51). There was no evidence for sex effects in either of the univariate models, and insomnia symptoms were found to be modestly heritable (~25% at Time 1 and ~22% at Time 2). In the longitudinal measurement model, which accounts for error of measurement, the heritability for the latent factor of insomnia symptoms increased substantially, and demonstrated quantitative sex differences. The heritability of the latent insomnia factor was ~59% in females and ~38% in males. CONCLUSIONS Genetic factors influence insomnia symptoms in adults, moreso for females than males, and these influences are largely stable over time. When taking into account measurement error, heritability estimates are substantial, but unique environmental factors continue to account for a large amount of variance in insomnia symptoms.
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Affiliation(s)
- Mackenzie J. Lind
- Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA
| | - Steven H. Aggen
- Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA
| | - Robert M. Kirkpatrick
- Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA
| | - Kenneth S. Kendler
- Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA
- Department of Human and Molecular Genetics, Virginia Commonwealth University, Richmond, VA
| | - Ananda B. Amstadter
- Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA
- Department of Human and Molecular Genetics, Virginia Commonwealth University, Richmond, VA
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Halder I, Matthews KA, Buysse DJ, Strollo PJ, Causer V, Reis SE, Hall MH. African Genetic Ancestry is Associated with Sleep Depth in Older African Americans. Sleep 2015; 38:1185-93. [PMID: 25845688 DOI: 10.5665/sleep.4888] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2014] [Accepted: 01/31/2015] [Indexed: 02/05/2023] Open
Abstract
STUDY OBJECTIVES The mechanisms that underlie differences in sleep characteristics between European Americans (EA) and African Americans (AA) are not fully known. Although social and psychological processes that differ by race are possible mediators, the substantial heritability of sleep characteristics also suggests genetic underpinnings of race differences. We hypothesized that racial differences in sleep phenotypes would show an association with objectively measured individual genetic ancestry in AAs. DESIGN Cross sectional. SETTING Community-based study. PARTICIPANTS Seventy AA adults (mean age 59.5 ± 6.7 y; 62% female) and 101 EAs (mean age 60.5 ± 7 y, 39% female). MEASUREMENTS AND RESULTS Multivariate tests were used to compare the Pittsburgh Sleep Quality Index (PSQI) and in-home polysomnographic measures of sleep duration, sleep efficiency, apnea-hypopnea index (AHI), and indices of sleep depth including percent visually scored slow wave sleep (SWS) and delta EEG power of EAs and AAs. Sleep duration, efficiency, and sleep depth differed significantly by race. Individual % African ancestry (%AF) was measured in AA subjects using a panel of 1698 ancestry informative genetic markers and ranged from 10% to 88% (mean 67%). Hierarchical linear regression showed that higher %AF was associated with lower percent SWS in AAs (β (standard error) = -4.6 (1.5); P = 0.002), and explained 11% of the variation in SWS after covariate adjustment. A similar association was observed for delta power. No association was observed for sleep duration and efficiency. CONCLUSION African genetic ancestry is associated with indices of sleep depth in African Americans. Such an association suggests that part of the racial differences in slow-wave sleep may have genetic underpinnings.
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Affiliation(s)
- Indrani Halder
- Department of Medicine, University of Pittsburgh, Pittsburgh, PA
| | - Karen A Matthews
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA
| | - Daniel J Buysse
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA
| | | | - Victoria Causer
- Department of Medicine, University of Pittsburgh, Pittsburgh, PA
| | - Steven E Reis
- Department of Medicine, University of Pittsburgh, Pittsburgh, PA
| | - Martica H Hall
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA
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Riemann D, Nissen C, Palagini L, Otte A, Perlis ML, Spiegelhalder K. The neurobiology, investigation, and treatment of chronic insomnia. Lancet Neurol 2015; 14:547-58. [PMID: 25895933 DOI: 10.1016/s1474-4422(15)00021-6] [Citation(s) in RCA: 317] [Impact Index Per Article: 35.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2014] [Revised: 01/16/2015] [Accepted: 01/29/2015] [Indexed: 12/31/2022]
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Budhiraja R, Siddiqi TA, Quan SF. Sleep disorders in chronic obstructive pulmonary disease: etiology, impact, and management. J Clin Sleep Med 2015; 11:259-70. [PMID: 25700872 DOI: 10.5664/jcsm.4540] [Citation(s) in RCA: 102] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2014] [Accepted: 12/21/2014] [Indexed: 01/18/2023]
Abstract
ABSTRACT Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality and may frequently be complicated by sleep disorders. Insomnia and obstructive sleep apnea are commonly encountered in patients with COPD. Nocturnal hypoxemia is also prevalent in COPD may occur despite adequate awake oxygenation and can be especially severe in rapid eye movement sleep. Additionally, several factors--some of them unique to COPD--can contribute to sleep-related hypoventilation. Recognition of hypoventilation can be vital as supplemental oxygen therapy itself can acutely worsen hypoventilation and lead to disastrous consequences. Finally, accruing data establish an association between restless leg syndrome and COPD--an association that may be driven by hypoxemia and/or hypercapnia. Comorbid sleep disorders portend worse sleep quality, diminished quality of life, and multifarious other adverse consequences. The awareness and knowledge regarding sleep comorbidities in COPD has continued to evolve over past many years. There are still several lacunae, however, in our understanding of the etiologies, impact, and therapies of sleep disorders, specifically in patients with COPD. This review summarizes the latest concepts in prevalence, pathogenesis, diagnosis, and management of diverse sleep disorders in COPD.
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Affiliation(s)
- Rohit Budhiraja
- Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, Tufts Medical Center, Boston, MA
| | - Tauseef A Siddiqi
- Division of Allergy, Critical Care, Pulmonary and Sleep Medicine, Department of Medicine, University of Arizona College of Medicine, Tucson, AZ
| | - Stuart F Quan
- Division of Allergy, Critical Care, Pulmonary and Sleep Medicine, Department of Medicine, University of Arizona College of Medicine, Tucson, AZ.,Divisions of Sleep Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
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Parthasarathy S, Vasquez MM, Halonen M, Bootzin R, Quan SF, Martinez FD, Guerra S. Persistent insomnia is associated with mortality risk. Am J Med 2015; 128:268-75.e2. [PMID: 25447616 PMCID: PMC4340773 DOI: 10.1016/j.amjmed.2014.10.015] [Citation(s) in RCA: 153] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2014] [Revised: 09/30/2014] [Accepted: 10/02/2014] [Indexed: 11/16/2022]
Abstract
BACKGROUND Insomnia has been associated with mortality risk, but whether this association is different in subjects with persistent vs intermittent insomnia is unclear. Additionally, the role of systemic inflammation in such an association is unknown. METHODS We used data from a community-based cohort to determine whether persistent or intermittent insomnia, defined based on persistence of symptoms over a 6-year period, was associated with death during the following 20 years of follow-up. We also determined whether changes in serum C-reactive protein (CRP) levels measured over 2 decades between study initiation and insomnia determination were different for the persistent, intermittent, and never insomnia groups. The results were adjusted for confounders such as age, sex, body mass index, smoking, physical activity, alcohol, and sedatives. RESULTS Of the 1409 adult participants, 249 (18%) had intermittent and 128 (9%) had persistent insomnia. During a 20-year follow-up period, 318 participants died (118 due to cardiopulmonary disease). In adjusted Cox proportional-hazards models, participants with persistent insomnia (adjusted hazards ratio [HR] 1.58; 95% confidence interval [CI], 1.02-2.45) but not intermittent insomnia (HR 1.22; 95% CI, 0.86-1.74) were more likely to die than participants without insomnia. Serum CRP levels were higher and increased at a steeper rate in subjects with persistent insomnia as compared with intermittent (P = .04) or never (P = .004) insomnia. Although CRP levels were themselves associated with increased mortality (adjusted HR 1.36; 95% CI, 1.01-1.82; P = .04), adjustment for CRP levels did not notably change the association between persistent insomnia and mortality. CONCLUSIONS In a population-based cohort, persistent, and not intermittent, insomnia was associated with increased risk for all-cause and cardiopulmonary mortality and was associated with a steeper increase in inflammation.
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Affiliation(s)
- Sairam Parthasarathy
- Department of Medicine, University of Arizona, Tucson; Arizona Respiratory Center, University of Arizona, Tucson.
| | | | - Marilyn Halonen
- Arizona Respiratory Center, University of Arizona, Tucson; BIO5 Institute, University of Arizona, Tucson
| | - Richard Bootzin
- Department of Psychology and Psychiatry, University of Arizona, Tucson
| | - Stuart F Quan
- Arizona Respiratory Center, University of Arizona, Tucson; Division of Sleep Medicine, Harvard Medical School, Boston, Mass
| | - Fernando D Martinez
- Arizona Respiratory Center, University of Arizona, Tucson; BIO5 Institute, University of Arizona, Tucson
| | - Stefano Guerra
- Department of Medicine, University of Arizona, Tucson; Arizona Respiratory Center, University of Arizona, Tucson; CREAL Centre and Universitat Pompeu Fabra, Barcelona, Spain
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